Cutting the cost of healthcare: can we afford it?

[WhipperSnapper]

They seem to ignore the fact that what this nation was built upon was people being free to go out and earn a living. Instead half the liberals (I'm conservative when it comes to finances but liberal otherwise) out there seem to want to go in and take from peopel who have made something of themselves and redistribute it to others.

One of the big issues is whether or not the people who are earning millions of dollars per year really earned it or are, in essence, expropriating compensation that members of the lower classes should be earning. The notion that everyone gets what they deserve is a religious dogma and article of free market faith.

Is it possible that many Wall Street money pushers and banksters are heavily overpaid? Is it possible that many CEOs and other executives are overpaid?

Some of the redistribution might not be a stealing of wealth from deserving people to parasites, but rather a return of what amounts to stolen money.

 

[senseamp]

We should be cutting out overhead. Insurance companies first and foremost.
No reason for them to get 20+% cut for doing nothing but making people's lives miserable.

 

[senseamp]

The funniest part of people like senseamp is that if they actually got their way... we would all leave the US.

The absolutely jealousy from some people on this board around people who make 100k, 200k, 300k+ or more a year is absolutely sickening.

It doesn't matter what profession it is - medical, engineering, tech, business anything really. All these people can talk about how it's so wrong for these people to make that kind of money.

They seem to ignore the fact that what this nation was built upon was people being free to go out and earn a living. Instead half the liberals (I'm conservative when it comes to finances but liberal otherwise) out there seem to want to go in and take from peopel who have made something of themselves and redistribute it to others.

It's really sickening what is happening to our society.

You can go out and make a 500+K in the private health care market. But Medicare should cut reimbursements. There is no reason for taxpayers to be on the hook for $300K+ doctor salaries.

 

[her209]

Profit by definition doesn't go towards care or creating jobs.

 

[Naeeldar]

One of the big issues is whether or not the people who are earning millions of dollars per year really earned it or are, in essence, expropriating compensation that members of the lower classes should be earning. The notion that everyone gets what they deserve is a religious dogma and article of free market faith.

Is it possible that many Wall Street money pushers and banksters are heavily overpaid? Is it possible that many CEOs and other executives are overpaid?

Some of the redistribution might not be a stealing of wealth from deserving people to parasites, but rather a return of what amounts to stolen money.

NO, you see that as an issue. I see it as jealousy. People need to get out and find a new job and make something of themselves if they are not happy.

I'm sick of listening to this kind of bs. THere are far to many people here who want to drive our country into socialism. People seem to be amazed by Universal Healthcare and other entitlement programs other countries run. I'll take one from senseamp and tell you to leave the country and head there.

 

[BarneyFife]

NO, you see that as an issue. I see it as jealousy. People need to get out and find a new job and make something of themselves if they are not happy.

I'm sick of listening to this kind of bs. THere are far to many people here who want to drive our country into socialism. People seem to be amazed by Universal Healthcare and other entitlement programs other countries run. I'll take one from senseamp and tell you to leave the country and head there.

I'm amazed at people like yourself who don't see the direction we are going. From manipulating money on Wall Street to insurance companies raising rates by 25% a year and expecting people/business to pay for it. Keep on smiling but your time will come. When you get fucked in the ass, just remember this post.

 

[Naeeldar]

I'm amazed at people like yourself who don't see the direction we are going. From manipulating money on Wall Street to insurance companies raising rates by 25% a year and expecting people/business to pay for it. Keep on smiling but your time will come. When you get fucked in the ass, just remember this post.

You do realize insurance companies have one of the smallest profit margins of almost eveyr single industry out there right?

I've been on this board for awhile now and people hardly ever call out thep harma companies which have a huge profit margin.

Quite frankly I'm sick of this demanding freebie entitlement attitude and this sense that everbody should be given the exact same of everything. You see it everyday with kids not being allowed to play sports at recess in school because somebody might get picked last and it will hurt their feelings. Or how everybody gets trophy because we are all winners, Quite frankly its this attitude that now extends into our adults today and what it equates to is a nation of weaklings. People who can't take care of themselves but can only whine about how it's not fair Bob has more than him.

 

[Xellos2099]

While insurance companies have shares of the blame but the raising cost has a lot more to do with pharmaceutical company and malpractice. Most of the time it is not the doctor visit that is expensive it is the damn medicines. Why is it that many of the life saving medicine is so expensive that average person is unable to afford it without insurance?

It is Greed, purely human greed and the US patent system and law system. In fact it is because of insurances that the pharmaceutical company dare to charge over inflated price because insurance pay for it, thus lead to raising insurance cost. One may say getting rid of insurance company will solve everything but the price will still remain high because the government will pay for it.

Also, did anyone ever notice the rapid increase of commercial of new drugs on TV? Thus the second problem, it SHOULD be the doctor who decide what medicine to give the patient, not the patient themselves as they are not health care profession. In many cases, the new drugs are a lot more expensive but it is not that much better than the cheaper, older drugs. The way foolish people figure that if the insurance company paid for it, why6 not go for the new and expensive drugs; thus even more strain to the system.

 

[Hayabusa Rider]

You can go out and make a 500+K in the private health care market. But Medicare should cut reimbursements. There is no reason for taxpayers to be on the hook for $300K+ doctor salaries.

You don't have a job, do you?

Tell you what. Cut reimbursements below the costs of providing service. Post your address and let people come to you to discuss your wisdom regarding health care.

 

[Hayabusa Rider]

Profit by definition doesn't go towards care or creating jobs.

By definition government doesn't make a profit. If a private insurance has a electronic snafu they can reverse the claim usually in real time. Had one happen a week ago with Medicare D. It will probably be another week before that's fixed. Why? Because of regulations and understaffing.

Too bad, but that's how Uncle Sam wants it.

 

[Slew Foot]

By definition government doesn't make a profit. If a private insurance has a electronic snafu they can reverse the claim usually in real time. Had one happen a week ago with Medicare D. It will probably be another week before that's fixed. Why? Because of regulations and understaffing.

Too bad, but that's how Uncle Sam wants it.

my wife applied as a medicare provider over two years ago, they still havent processed her paperwork yet. shes been billing under her partners in the meantime. the private companies finished the paperwork in less than a month.

 

[Hayabusa Rider]

my wife applied as a medicare provider over two years ago, they still havent processed her paperwork yet. shes been billing under her partners in the meantime. the private companies finished the paperwork in less than a month.

They love paperwork don't they? They require it, but they seem to feel no need to deal with it themselves.

The woman who works for me had a father in law who died about a year ago. The govt was to pick up the tab, but first there needed to be a determination made. In the meantime the facility admitted him and he lasted about four months. Last she heard the "home" may get a determination as to whether or not they'll get paid in another year or two. Ain't this a great system?

 

[WhipperSnapper]

NO, you see that as an issue. I see it as jealousy. People need to get out and find a new job and make something of themselves if they are not happy.

Why would that not be an issue if it's true? Why is some sort of societal structure that results in manifest injustice (some people getting much more than they really deserve at the expense of others getting less) not an issue?

I'm sick of listening to this kind of bs. THere are far to many people here who want to drive our country into socialism. People seem to be amazed by Universal Healthcare and other entitlement programs other countries run. I'll take one from senseamp and tell you to leave the country and head there.

I would do it if I could gain citizenship in one of those evil Western European people's states, if I spoke the language, and most importantly if I could easily port over my professional licensure (not happening).

Maybe you should follow Ayn Rand's advice and check your premises and question some of your economic beliefs instead of advocating the free market as a dogma.

The quality of life for people in many of those Western European nations is much higher than it is here. They don't work as many hours and don't have to worry about health insurance concerns. They don't have as many poor people nor as many wealthy people.

Why do you think real free market health care would be superior to the proven socialized systems? Do you think our current system where we're spending far far more than any other nation in the world (17% of GDP and also in terms of absolute dollars per capita) while still having tens of millions of people uninsured and underinsured is better than those evil socialist systems?

If free market policies are so great, why is that our nation is in an economic depression right now? Under free market policies the businesses were able to merge the U.S. labor market with the billions of impoverished people in third world nations, resulting in global labor arbitrage and the eventual reduction of the American standard of living to third world levels.

I'm so sick of dogmatist-sheeple who can't make an argument.

 

[WhipperSnapper]

Quite frankly I'm sick of this demanding freebie entitlement attitude and this sense that everbody should be given the exact same of everything.

Who said that? Where are you finding that message? I think people are tired of the injustice of some people receiving large amounts of compensation for little work at the expense of hard working people. That's not an entitlement attitude; that's a justice/meritocracy attitude.

As for health care, the reason people are advocating socialized medicine is because it has proven itself to be far far superior to our current system--other nations spend much less and have 100% coverage, zero medical bankruptcies, a more contented populace, and a business climate and economy that isn't burdened by health insurance concerns.

There's more to it than rote egalitarianism.

 

[WhipperSnapper]

You do realize insurance companies have one of the smallest profit margins of almost eveyr single industry out there right?

Profit margins can be misleading because they don't take into account the large profits that higher level executives can make. If we were to regard compensation beyond a reasonable $500,000/year as "profit" it might be a different story.

The other issue is not merely one of profit but rather huge inefficiency resulting from everything associated with the insurance industry. The wasted money and inefficiency manifests itself in ways other than reported profits. When a large percentage of the people employed by the health care industry have nothing to do with providing direct health care, there's waste in the system somewhere--like all the insurance company employees, medical billing specialists, insurance brokers and consultants, company benefits plan managers, etc.

 

[rchiu]

Profit margins can be misleading because they don't take into account the large profits that higher level executives can make. If we were to regard compensation beyond a reasonable $500,000/year as "profit" it might be a different story.

The other issue is not merely one of profit but rather huge inefficiency resulting from everything associated with the insurance industry. The wasted money and inefficiency manifests itself in ways other than reported profits. When a large percentage of the people employed by the health care industry have nothing to do with providing direct health care, there's waste in the system somewhere--like all the insurance company employees, medical billing specialists, insurance brokers and consultants, company benefits plan managers, etc.

Do you have any idea what the heck you are talking about? Do you want to take the risk of paying $1Million+ in medical bill if you need certain specialized treatment? Removing that risk for you by averaging out everyone's medical cost into a constant monthly payment is what insurance companies do for you. Calculating what that monthly payment should be is what insurance companies do for you. Getting the necessary paper work and evidence to reduce false claim and keep the monthly payment reasonable is what those people do for you.

Like other poster pointed out, insurance company has one of the lowest profit margin. Just a quick example, AETNA made ~$200M on revenue of ~$8 billion for like 2.5%. Talking about high paid execs, how many billionaires come from insurance industry? Quick browse the Forbes 50 richest American, I see bunch of people from Walmart, tech industry, hedge fund, investment, but no one from insurance industry. When I graduated from MBA, people talked about being trader, high tech startup guy, consultant, I don't remember anyone saying anything about insurance broker.

Maybe insurance made everyone insensitive to cost of healthcare, that'd be a valid complain about insurance. But that's not really insurance company's fault. There has to be other ways to control healthcare cost. If supply and demand is messed up because of insurance, government need to step in and regulate. Unless all American agree that we just do away with insurance and if you get cancer or some serious illness with no money to pay, tough luck.

 

[Naeeldar]

Why would that not be an issue if it's true? Why is some sort of societal structure that results in manifest injustice (some people getting much more than they really deserve at the expense of others getting less) not an issue?

I would do it if I could gain citizenship in one of those evil Western European people's states, if I spoke the language, and most importantly if I could easily port over my professional licensure (not happening).

Maybe you should follow Ayn Rand's advice and check your premises and question some of your economic beliefs instead of advocating the free market as a dogma.

The quality of life for people in many of those Western European nations is much higher than it is here. They don't work as many hours and don't have to worry about health insurance concerns. They don't have as many poor people nor as many wealthy people.

Like I said, I prefer what we have here in the US. There is opportunity here and I sure as hell don’t mind working 45-50 hour weeks (regularly) and as much as 60 hours if needed to get ahead and make extra money. It allows me to things I want to do with my life – like visit a new island every single year at a Sandals resort. I’m heading to the Bahamas in November for 7 nights and I’ve done Jamaica and St. Maarten already and I just turned 27. Had I lived in one of those countries I would work less but I’d make less too – NO THANKS.

Why do you think real free market health care would be superior to the proven socialized systems? Do you think our current system where we're spending far far more than any other nation in the world (17% of GDP and also in terms of absolute dollars per capita) while still having tens of millions of people uninsured and underinsured is better than those evil socialist systems?

Because I like not having the quality of MY care reduced or rationed because a piece of the money I pay goes towards paying for healthcare for others. You want healthcare for people under age of 18? Ok I'll pay taxes for that. Once your an adult your on your own.

There are MANY issues with socialized healthcare as well that you are ignoring. There is a reason people with money who live in Canada come to the US. There are reasons why people fly from overseas to here for more advanced treatments.

The fact is all those new treatments would not be discovered if it were not for the US. BUt we pay for it.

Also everybody asking for Universal Healthcare forgets one HUGE issues. We have a far larger population than any of those countries and worse we are spread out across the US. There systems wouldn't even work here in the US because of that.

If free market policies are so great, why is that our nation is in an economic depression right now? Under free market policies the businesses were able to merge the U.S. labor market with the billions of impoverished people in third world nations, resulting in global labor arbitrage and the eventual reduction of the American standard of living to third world levels.

I'm so sick of dogmatist-sheeple who can't make an argument.

Ok. So the rest of the world is not impacted in a huge way by the economy? There are only a few countries that have recovered at this point - Germand and I want to say norway (one of those countries). the second country was also because they learned from the housing bubble issue a decade ago. The fact is countries everywhere are struggling.

 

[MomentsofSanity]

There are MANY issues with socialized healthcare as well that you are ignoring. There is a reason people with money who live in Canada come to the US. There are reasons why people fly from overseas to here for more advanced treatments.

The fact is all those new treatments would not be discovered if it were not for the US. BUt we pay for it

This bullshit meme again? Go find me some stats on Canadians going to the US for medical treatment. Don't cite me some story about a politician or someone. Find me actual numbers. Start with the surveys done in Phantoms in the Snow.

Heres a different question for you instead. Explain to me why over and over again, every poll, 90%+ of the Canadian population soundly rejects the notion of an American style health system. What do 90% of en entire popultion ever agree on? The whole Canadians want what we have thing is absolutely shit. There's a reason Tommy Douglas was selected by the people of Canada as the single greatest Canadian

And you'd do well to learn what new tretments would not be discovered if it weren't for Canada or any ot the other countries of the world..

 

[the DRIZZLE]

One of the big issues is whether or not the people who are earning millions of dollars per year really earned it or are, in essence, expropriating compensation that members of the lower classes should be earning. The notion that everyone gets what they deserve is a religious dogma and article of free market faith.

Is it possible that many Wall Street money pushers and banksters are heavily overpaid? Is it possible that many CEOs and other executives are overpaid?

Some of the redistribution might not be a stealing of wealth from deserving people to parasites, but rather a return of what amounts to stolen money.

I don't disagree that there are inefficiencies in the system that lead to people getting more than they "deserve". However the proper way to fix it is not a punitive tax code. Fix what's wrong in the system. In this case that might be finding ways to increase the number of doctors or reduce the number of years of training required.

 

[Darwin333]

I read an article that put forth a good argument (at least it sounded good to me) that the US is effectively subsidizing medical innovation for much of the rest of the world. It stated that we basically pay for all or most of the R&D costs via much higher prices for drugs, new medical devices, machines, etc... while other countries purchase the same stuff from the same companies for far cheaper. Either those countries simply can not afford to pay the higher price or they flat out refuse and drug maker XYZ would rather make $.25 a pill than nothing or even worse having it ripped off while the countries officials look the other way.

I don't have nearly enough knowledge of the field to know how accurate this is and I am sure if it is that it is only one piece of the puzzle. If true it is definitely a good place to start though.

 

[Naeeldar]

or reduce the number of years of training required.

Seriously? We can't pay for the overall cost so lets make it so the quality drops? And lawsuits would then go up and then that would cause malpractice to go up. Not a good idea.

 

[WhipperSnapper]

Do you have any idea what the heck you are talking about? Do you want to take the risk of paying $1Million+ in medical bill if you need certain specialized treatment? Removing that risk for you by averaging out everyone's medical cost into a constant monthly payment is what insurance companies do for you. Calculating what that monthly payment should be is what insurance companies do for you. Getting the necessary paper work and evidence to reduce false claim and keep the monthly payment reasonable is what those people do for you.

Uh, yeah, I get that. My point is that there may be other systems of providing health care that are superior and more efficient than having private insurance companies or insurance companies at all. What if we could reduce a hospital's billing department to a single drawer in a single desk?

Like other poster pointed out, insurance company has one of the lowest profit margin. Just a quick example, AETNA made ~$200M on revenue of ~$8 billion for like 2.5%. Talking about high paid execs, how many billionaires come from insurance industry?

The complaint is not that the insurance execs are becoming billionaires, just that many are earning over a million/year. I seem to remember reading an article a while back about how 40 execs at one company received $100,000 bonuses or had million dollar/year incomes or some such.

Maybe insurance made everyone insensitive to cost of healthcare, that'd be a valid complain about insurance. But that's not really insurance company's fault. There has to be other ways to control healthcare cost.

It sounds like you're (intentionally?) ignorant about other means of providing health care. This video about how other first world industrialized nations do it may be of interest to you.

Sick Around the World

If supply and demand is messed up because of insurance, government need to step in and regulate. Unless all American agree that we just do away with insurance and if you get cancer or some serious illness with no money to pay, tough luck.

The problem is not a supply-and-demand problem. It's a massive inefficiency problem.

 

[RocksteadyDotNet]

1: You arn't including wages in profit.

Our heart surgeons make 400k a year, not 1 million a year. Our nurses make 70k, not 140k. It adds up.

2: We "ration" healthcare. It's hard to get numbers, but I bet a lot of U.S. money is spent on bullshit that we would spend on heart surgeory or cancer.

3: Efficiency of volume. Our gov owns the hospitals. It's a lot easier to stretch dollars when you arn't paying set fees to a 3rd party.

Long story short; you guys are fucked.

Short of nationalising your health care system, your costs will never come under control.

But yeah, as long as you don't become like DA EVIL SOCIALIST, I guess things will be ok.

 

[WhipperSnapper]

Like I said, I prefer what we have here in the US. There is opportunity here and I sure as hell don’t mind working 45-50 hour weeks (regularly) and as much as 60 hours if needed to get ahead and make extra money. It allows me to things I want to do with my life – like visit a new island every single year at a Sandals resort. I’m heading to the Bahamas in November for 7 nights and I’ve done Jamaica and St. Maarten already and I just turned 27. Had I lived in one of those countries I would work less but I’d make less too – NO THANKS.

Your attitude sounds like, "I've got mine, F everyone else." It sounds like you were blessed to be born with great interviewing and people skills or some sort of family connections (lucky sperm club) to get your great job. Let me guess, you majored in a marketable field and worked really hard and having good luck and avoiding bad luck played no part in your success, right?

Wasn't there an article published by The Economist a couple years back showing that the U.S. has more class stratification than those evil semi-socialist European countries (you're very likely to end up in the class you're born into)? If true, it's evidence that we don't have a real meritocracy.

I found one of the articles: Social Mobility and Inequality

Parental income is a better predictor of a child’s future in America than in much of Europe, implying that social mobility is less powerful. Different groups of Americans have different levels of opportunity. Those born to the middle class have about an equal chance of moving up or down the income ladder, according to the Economic Mobility Project. But those born to black middle-class families are much more likely than their white counterparts to fall in rank. The children of the rich and poor, meanwhile, are less mobile than the middle class’s. More than 40% of those Americans born in the bottom quintile remain stuck there as adults.

Here's the other one:

Meritocracy in America

With our nation's huge amount of unemployment and underemployment, there doesn't seem to be much opportunity left. Tell the 17 million people with college degrees who (presumably menial) jobs that don't require a college degree about all of the opportunity that's available. Or tell it to the underemployed PhD scientists and other people who "did everything right".

Because I like not having the quality of MY care reduced or rationed because a piece of the money I pay goes towards paying for healthcare for others. You want healthcare for people under age of 18? Ok I'll pay taxes for that. Once your an adult your on your own.

Are you open to the possibility that you yourself or a loved one could end up broke and in need of health care yet unable to afford it? Even though you think you're really special and that ill fortune could never befall you, it's possible (unless you were born into the lucky sperm club and have wealthy parents). You could lose your position in any number of ways that have nothing to do with your own actions. For example, you could be falsely accused of rape or child molestation or whatever and end up losing your job and career in spite of getting acquitted. Or you could rub an executive the wrong way at some point and end up getting canned and then through bad luck be unable to find another position in your field, rendering yourself unemployable in it after a period of months.

There are MANY issues with socialized healthcare as well that you are ignoring. There is a reason people with money who live in Canada come to the US. There are reasons why people fly from overseas to here for more advanced treatments.

So why aren't the Canadians, French, and British clamoring for the American system? They're terrified of our system and think we're retarded for having it. Wealthy people will always be able to afford and seek out the very best doctors and exquisite treatments. There's nothing unusual about that.

Also everybody asking for Universal Healthcare forgets one HUGE issues. We have a far larger population than any of those countries and worse we are spread out across the US. There systems wouldn't even work here in the US because of that.

That's a BS argument that seems to be making the rounds. Other nations have farmers and people living in rural areas. There's no reason why a successful system that works on a small scale can't scale up to handle more people. We have more people but we also have more aggregate money to spend on health care.

Are you trying to argue that a core component of why the U.S. spends 17% of its GDP on health care is one of population density? Are you saying that rural hospitals result in gross inefficiency?

Ok. So the rest of the world is not impacted in a huge way by the economy? There are only a few countries that have recovered at this point - German and I want to say norway (one of those countries). the second country was also because they learned from the housing bubble issue a decade ago. The fact is countries everywhere are struggling.

It's funny how two of the evil socialist countries seem to be doing well.

 

[the DRIZZLE]

Seriously? We can't pay for the overall cost so lets make it so the quality drops? And lawsuits would then go up and then that would cause malpractice to go up. Not a good idea.

Yes, something has to give. We can't continue to spend an ever increasing percentage GDP on healthcare. We can either get less healthcare, or reduce the quality somewhat. For example if we could reduce the quality 5% for a 25% reduction in costs than that looks like a smart move to me. This is part of the reason single payer is cheaper, the quality is lower. You are assuming that the current system of medical training is optimal, it might be unnecessarily long. We should at least examine the issue.