Don't you dread single payer?

[dank69]

Here Genx, since your ego is preventing you from hitting the Google button let me help you out:

Info from insurance company (Aetna)

An increasingly important factor driving hospital price increases is consolidation of the hospital industry. Hospital mergers and acquisitions jumped by 33 percent between 2009 and 2010. Research shows that hospital market concentration leads to increases in the price of hospital care. In fact, price increases exceeded 20 percent when mergers occurred in concentrated markets.

 

[dank69]

So far we have you dodging questions, shooting down your own fantasy straw man arguments, and calling names. Clearly I am the one below a junior high level debate team.

Says the guy rewording my direct question to him three times so he isn't forced to answer it.

 

[Genx87]

Here Genx, since your ego is preventing you from hitting the Google button let me help you out:

Info from insurance company (Aetna)

Well holy shit there is proof of my "not the sole reason" for all of our health care costs outpacing inflation argument. Nothing gets by you danke69.

 

[dank69]

Another link for Genx, this time from the liberal organization we call Forbes.

Once the physician impact on healthcare costs is placed in proper perspective, the true role of other key factors can be examined more clearly.
The first area is technology. There is consensus among experts that technology is the most important driver of healthcare spending increases over time. Installing and implementing electronic health records is costly – often as much as $25,000 per doctor for a system and a monthly subscription fee on top of that – and requires significant resources.

 

[Genx87]

Says the guy rewording my direct question to him three times so he isn't forced to answer it.

Im not sure how many times explaining how increasing costs will reduce demand I can write before it sinks into your thick skull.

Glenn provides another good example as well as yllus explaining what is going on in Canada. But it still evades you.

 

[BoberFett]

I don't really want a doctor motivated by profit, do you?

What DO you want your doctor motivated by?

 

[yllus]

Spend hours at the ER because I don't have to pay for it but if I have to pay a small copay, fuck that. Seems legit.

It's meant purely a psychological barrier, not a fiscal one. And it does work.

CFAH - Even Small Increases in Copays Affect Use of Children's Healthcare

Increases in copayments of only a few dollars for ALL Kids, Alabama's Children's Health Insurance Program (CHIP), led to declines in the use of several healthcare services for the children they affected, reveals a study in Health Services Research. Use of services within ALL Kids with no increase in copayments did not decline, nor was a decline in services observed for children whose copayments did not rise.

...

Cost increases ran from $3 to $15, but were mostly in the $3 to $5 range.

"Even these relatively small increases in copay still have some effect," said Bisakha Sen, Ph.D., associate professor at the University of Alabama at Birmingham. She and her co-authors evaluated which health services in ALL Kids were used before and after the change in copayment. They also looked at the use of services that had no change in copayment and at enrollees who were not subject to a copayment increase.

While most of the decreases were quite small - tenths of a percentage point - these added up to appreciable numbers when factored over all the children enrolled in a given month, the study noted. For example, the gap of between 0.07 percent and 0.09 percent of expected versus actual in-patient stays at a hospital in November 2003 compared to after the policy change in November 2004 translates to between 44 and 57 fewer in-patient visits that month.

No similar decrease in use was seen for preventive care, such as well-child visits and preventive dentistry, Sen said. “We did find evidence of shifting toward more use of preventive services after these changes happened,” Sen added. ”We anticipate that greater use of preventive services will preempt some of these health offsets down the road.”

“I think the data support what physicians have felt for years,” said Grant Allen, M.D., president of the Alabama chapter of the American Academy of Pediatrics. “I find that the research seems to support that, over time, populations make decisions about health care based on cost. 'Free' care is accessed most often and even small copays reduce use of services.”

 

[dank69]

It's meant purely a psychological barrier, not a fiscal one. And it does work.

CFAH - Even Small Increases in Copays Affect Use of Children's Healthcare

At no point did I agrue that it would have no effect. I am arguing that healthcare inflation is not primarily driven by cost to consumer.

On top of that, that source is describing less healthcare for children as some sort of net positive which is one of the definitions of insane.

 

[dank69]

What DO you want your doctor motivated by?

Keep reading chief.

 

[BoberFett]

I guess, if altruism means I expect a doctor to want to do what's best for me instead of rushing through my appointment in order to make his tee time at the country club when I had to wait months for the appointment in the first place.

See, I'm not looking for doctors to work for free here. I just prefer doctors who hold the oath they take in higher regard than their paycheck. That doesn't mean the paycheck isn't a concern, it just shouldn't be the top concern.

You really do live in fantasy-land don't you?

Do you do your job because you love it, or because they pay you? If your employer told you they were cutting your pay in half, would you work harder?

 

[dank69]

Im not sure how many times explaining how increasing costs will reduce demand I can write before it sinks into your thick skull.

Glenn provides another good example as well as yllus explaining what is going on in Canada. But it still evades you.

Glenn's example as I already pointed out was for elective surgery. Who gives a flying fuck about elective surgery?

Your awesome solution will lead to people being even less able to afford healthcare costs, plain and simple.

 

[BoberFett]

WTF is wrong with you characterizing the problem as a demand issue? Are you fucking serious with this shit? Do you have stats showing that reducing the amount of people going to the doctor unnecessarily will make any significant change to our current demand? If you don't, you have nothing supporting your position and we are free to characterize your position as "people just need to stop getting sick or hurt."

After further review, I think somebody just needs to put this animal down. He's clearly foaming at the mouth, and a danger to those around him.

After 36 different infractions, vacations, and warnings issued by 14 different mods and Admins, you were warned that your next vitriolic attack on this level in P&N would get you 2 months off.

Perknose
Forum Director

 

[dank69]

You really do live in fantasy-land don't you?

Do you do your job because you love it, or because they pay you? If your employer told you they were cutting your pay in half, would you work harder?

Keep reading chief. Wait until you get to the part where I explain that I never said paycheck shouldn't be a concern, just that my well being should be a bigger concern.

 

[glenn1]

At no point did I agrue that it would have no effect. I am arguing that healthcare inflation is not primarily driven by cost to consumer.

No shit sherlock, that's the entire point. Health insurance or single-payer both serve to insulate the end consumer from the price of the services they consume, and thus there is no natural constraint on additional consumption. Even though you might never have heard of it, there's even a term for the phenomenom:

http://lmgtfy.com/?q=tradegy+of+the+commons

 

[Juddog]

No shit sherlock, that's the entire point. Health insurance or single-payer both serve to insulate the end consumer from the price of the services they consume, and thus there is no natural constraint on additional consumption. Even though you might never have heard of it, there's even a term for the phenomenom:

http://lmgtfy.com/?q=tradegy+of+the+commons

Just because people get state sponsored healthcare doesn't mean that suddenly everybody is going to want to sit in a hospital all day. People get state paid for firetrucks; does that mean they want to continuously burn their house down? You are being really obtuse here.

 

[nickbits]

Glenn's example as I already pointed out was for elective surgery. Who gives a flying fuck about elective surgery?

Just because something isn't life threatening doesn't mean it isn't important.

 

[glenn1]

Just because people get state sponsored healthcare doesn't mean that suddenly everybody is going to want to sit in a hospital all day. People get state paid for firetrucks; does that mean they want to continuously burn their house down? You are being really obtuse here.

No, it means that once they're already in the hospital, if they aren't directly responsible for their costs they have no reason not to choose the most expensive and exhaustive options. The marginal cost to the end consumer for additional services is zero (absent opportunity costs in time, etc.), so there will be infinite demand.

I explained it earlier in the thread.

http://forums.anandtech.com/showthread.php?p=35612535#post35612535

 

[dank69]

Just because something isn't life threatening doesn't mean it isn't important.

What are you trying to say here? That you want to pay extra taxes so poor people can get nose jobs?

 

[Juddog]

No, it means that once they're already in the hospital, if they aren't directly responsible for their costs they have no reason not to choose the most expensive and exhaustive options. The marginal cost to the end consumer for additional services is zero, so there will be infinite demand.

I explained it earlier in the thread.

http://forums.anandtech.com/showthread.php?p=35612535#post35612535

Infinite demand? What the fuck are you smoking? Look at any of the other countries, you know, the 37 ones that all score better than the US in terms of healthcare, and tell me which ones have their hospitals booked 24/7 because of "infinite demand".

You are so full of shit that it's starting to come out of your mouth when you talk.

 

[dank69]

No, it means that once they're already in the hospital, if they aren't directly responsible for their costs they have no reason not to choose the most expensive and exhaustive options. The marginal cost to the end consumer for additional services is zero, so there will be infinite demand.


I explained it earlier in the thread.

http://forums.anandtech.com/showthread.php?p=35612535#post35612535

So I guess all those extra tests and procedures don't take extra time?

No, no. You guys are right. The best way to cut down on unnecessary procedures is to make them more expensive for everyone including all those that actually need them. Reducing that to it's purest form, the best way to make healthcare less expensive is to make it more expensive for the people that need it and less expensive for insurance companies.

 

[yllus]

At no point did I argue that it would have no effect. I am arguing that healthcare inflation is not primarily driven by cost to consumer.

On top of that, that source is describing less healthcare for children as some sort of net positive which is one of the definitions of insane.

Actually, you said:

Spend hours at the ER because I don't have to pay for it but if I have to pay a small copay, fuck that. Seems legit.

I just found one random article that says otherwise; again, we had a month-long debate about this in Canada years ago, and it occasionally comes back up again (health care is now more than 50% of our federal government's spending, we look for ways to keep it low). You are simply incorrect in your statement that a small copay does not deter people to a greater degree than the wait itself does.

People here do take their small children to the ER for sniffles. I can understand that to a certain extent, but it still needs to be minimized if possible.

Just because people get state sponsored healthcare doesn't mean that suddenly everybody is going to want to sit in a hospital all day.

You'd be surprised. They may not enjoy it, but they'll go.

 

[soulcougher73]

Nope. I welcome it with open arms.

 

[dank69]

Actually, you said:



I just found one random article that says otherwise; again, we had a month-long debate about this in Canada years ago, and it occasionally comes back up again (health care is now more than 50% of our federal government's spending, we look for ways to keep it low). You are simply incorrect in your statement that a small copay does not deter people to a greater degree than the wait itself does.

People here do take their small children to the ER for sniffles. I can understand that to a certain extent, but it still needs to be minimized if possible.



You'd be surprised. They may not enjoy it, but they'll go.

Your article made no claims about ER use and actually said:

No similar decrease in use was seen for preventive care

Did you even read your own link?

 

[Juddog]

So I guess all those extra tests and procedures don't take extra time?

No, no. You guys are right. The best way to cut down on unnecessary procedures is to make them more expensive for everyone including all those that actually need them. Reducing that to it's purest form, the best way to make healthcare less expensive is to make it more expensive for the people that need it and less expensive for insurance companies.

Sounds like you've exposed who hired him to shill up the forums.

 

[glenn1]

Keep reading chief. Wait until you get to the part where I explain that I never said paycheck shouldn't be a concern, just that my well being should be a bigger concern.

So your well being is a bigger concern, but you're willing to delegate those decisions to a government bureaucrat who could give a shit less about you as an individual since they're focused on the "greater good" of the larger population?

Okay, you're in a single payer system. Your taxes pay for your medical care, and there are effectively no out-of-pocket costs to you. You go to the hospital complaining of some kind of pains. The doctor looks you over and says it's likely indigestion, but there's also a small chance (let's say 10% for sake of argument) you could suffer a fatal heart attack in the next few minutes that could be detected via blood tests. The government paying the bill says it's an "elective test" and refuses to allow it since for the price of your test, the government could treat 20 other patients with other ailments.

Still think that consumer demand only impacts either elective or non-elective healthcare? To someone else, *any* money spent on healthcare for you is elective.