Quietly, Obamacare is doing something even more ambitious than insurance expansion

[yllus]

Actually will increase costs. The first thing you learn in business is when you have more business than you can handle RAISE prices until they have second thoughts about coming. You see when you have a fixed supply of labor and give more poeple access to that labor they can charge more, way more. Especially in medicine since ppl like living.

There is a reason ALL UHC countries control the suppliers as well.

Funny, that's what I learned to do as a software developer contractor as well: Never say "no, I'm too busy to do the work," just name a figure that's high enough that you would gladly find the time to do the work for. If they accept, great, you make a premium rate. If they don't, no loss as you weren't to find the time anyways.

 

[micrometers]

well, yeah. I've always held that Obamacare is significantly better thought out than the cable news idiots will say.

 

[Zebo]

I know that all my family members, who are teachers, are sure as hell not checking the box with anyone with an "R" after their name.

Lots on the let hate it too or have you forgotten the bribes it took to get dean and kusinish to stfu and the heated debate within the democratic party?

 

[crownjules]

I work for a healthcare software company that develops for insurance providers. One of the big areas we have been working on is our pay-for-peformance analytics. I was talking to the guy in charge of developing and marketing that, a really intelligent doctor who used to be Chief Medical officer at an insurer some years ago. He stated that up until the last few years most insurers don't care about performance of their physicians and specialists and surgeons. All of the higher costs they may incur is just passed on to the insured through higher premiums with little to no questions asked. Only now is it becoming something they look at to keep their costs contained.

No doubt that's why some of those surgeons quit. They were getting away with more money then they might get if someone were closely scrutinizing their work for it's quality rather than quantity.

 

[Phokus]

Actually will increase costs. The first thing you learn in business is when you have more business than you can handle RAISE prices until they have second thoughts about coming. You see when you have a fixed supply of labor and give more poeple access to that labor they can charge more, way more. Especially in medicine since ppl like living.

There is a reason ALL UHC countries control the suppliers as well.

How does Obamacare increase costs? If anything, we need to destroy the AMA's grip on the supply of doctors coming out of med school, this has nothing to do with obamacare.

 

[Zebo]

How does Obamacare increase costs? If anything, we need to destroy the AMA's grip on the supply of doctors coming out of med school, this has nothing to do with obamacare.

More access (demand) virtually fixed supply (as you note).

Why HC costs so much today look no further than fanicailization given to you by insurance companies when increased demand. Not malpractice (2%) or any other red herring. When you financialize things it raises prices. This was true with housing when a hairdresser could get a nodoc $700,000 loan and homes went trough the roof. It's true with public education where every idoit can get a student loan, and now has to because costs are so high due to demand. And it's true with HC.

In the 1960s your parents wrote a check to the doctor. Middle class only had catastrophic coverage. Doctors were cheap. Bankruptcy due to medical costs was extremely rare. Today thanks to comprehensive coverage, which is just another form of finacialization, seeing a doctor is very expensive. Why? Because those who have a demand for health care now can (by law) always receive it like a house or education and HC like anything else follows supply and demand.

Why you think ANYONE that has UHC, which 'insures' everyone, has price controls and fixed wages?

Our 'uniquely American solution' of insuring everyone while not regulating the supply end will be a total fail.

 

[DrPizza]

Prior to obamacare, there was already a push to reward/penalize hospitals on the readmission rate. It has led to a lot of changes at hospitals about how they care for patients, particularly in regard to patient education. If they can't convince patients to follow their guidelines (take your medicine!) and the patient is readmitted, it costs the hospital. Thus, they have to work a lot harder on the patient education to convince the patient to follow the guidelines set forth by his/her doctor.

Likewise, hospitals end up making a greater effort to make sure the supports are in place to allow the patient to go home with less risk of readmission, because the proper care can be given outside the hospital setting, rather than the patient thinking they can make it at home, then giving up and returning.

 

[shadow9d9]

Lots on the let hate it too or have you forgotten the bribes it took to get dean and kusinish to stfu and the heated debate within the democratic party?

Well, the democratic party is not "left"... It has the hick state democrats and the moderate democrats.

 

[theeedude]

Actually will increase costs. The first thing you learn in business is when you have more business than you can handle RAISE prices until they have second thoughts about coming. You see when you have a fixed supply of labor and give more poeple access to that labor they can charge more, way more. Especially in medicine since ppl like living.

There is a reason ALL UHC countries control the suppliers as well.

There is also a reason ALL UHC countries spend a lot less than we do on health care and get better results. The flaw with your argument is that if people have health coverage, they can get preventative and early care, which is much cheaper than ER care, with much better outcomes. So you are right, we have a limited supply of labor, but preventative care is much less labor intensive than caring for people who wait until they are really sick to go to the ER. The productivity (outcome/labor) increases significantly if care is provided early on or a condition is prevented.

 

[Zebo]

There is also a reason ALL UHC countries spend a lot less than we do on health care and get better results. The flaw with your argument is that if people have health coverage, they can get preventative and early care, which is much cheaper than ER care, with much better outcomes. So you are right, we have a limited supply of labor, but preventative care is much less labor intensive than caring for people who wait until they are really sick to go to the ER. The productivity (outcome/labor) increases significantly if care is provided early on or a condition is prevented.

There is some truth to preventative care being helpful with costs but it does not change the dynamic of being a service you NEED and increasing demand will raise prices. Again, national doctors are paid X in Germany or Taiwan and drug prices/medical devices are set by the state for a good reason.

They don't want to pay 20% of GDP in HC and have doctors and phamacists being walking corporations.

 

[Hayabusa Rider]

The devil is in the details of course. I'd have to see what passes for dependable and how much savings are offset by cost shifting.

Medicaid recently made changes to save about five bucks which requires providers to spend an hour or so to work around increasing the real costs. Assuming that it's done correctly I have no problems with payment being linked to outcomes.

 

[piasabird]

My favorite trick is when doctors keep prescribing the most expensive medication made so they can get kickbacks from the pharma companies.

 

[Hayabusa Rider]

There is some truth to preventative care being helpful with costs but it does not change the dynamic of being a service you NEED and increasing demand will raise prices. Again, national doctors are paid X in Germany or Taiwan and drug prices/medical devices are set by the state for a good reason.

They don't want to pay 20% of GDP in HC and have doctors and phamacists being walking corporations.

You do realize that the difference in compensation isn't anywhere close to the difference on costs, right?

 

[cybrsage]

Our 'uniquely American solution' of insuring everyone while not regulating the supply end will be a total fail.

Agreed. What we need to do is look over the various healthcare systems of the world and create one which takes their best parts and does not include their worst parts. Then tailor it to our unique nation. What works in Japan will not work in Albania, for example.

Each US state should create their own system for their own state (like each EU nation creates their own system for their own nation) tailored for the needs of the people of that state. Each state can then learn from the mistakes of other states, and each system will get stronger and better.

It is also FAR easier to hold state representatives accountable than it is fed representatives.

 

[theeedude]

There is some truth to preventative care being helpful with costs but it does not change the dynamic of being a service you NEED and increasing demand will raise prices.

It's not the same service that you are increasing demand for. You are shifting demand from expensive ER care to cheaper preventative and early care, which is a lot less labor intensive. If you treat something early or prevent it, you can do it with nurse practitioners for very little money. If you wait until it turns into a health emergency, you are going to spend a lot of money on expensive specialists, and have a worse outcome. Like I said, there is a very good reason countries with UHC spend a lot less on health care and get better outcomes.

 

[Zebo]

You do realize that the difference in compensation isn't anywhere close to the difference on costs, right?

Are you sure? I'm not blaming professional 100% - These countries don't have the layers either. Half HC are skimmers off the top. Insurance, Paperwork companies, distributors etc. - but there are no 2-5 million dollar a year surgeons in those countries like here. My brother owns pharmacies and makes almost 7 figures too. The margins are outrageous, I've seen them. Compared to say selling booze which I do.

I make em sick he fixes em

 

[ElFenix]

The Patient Protection and Affordable Care Act (PPACA) is a United States federal statute signed into law by President Barack Obama on March 23, 2010.

The program launched in June 2009 with a checklist of quality metrics.

:hmm:

 

[Hayabusa Rider]

It's not the same service that you are increasing demand for. You are shifting demand from expensive ER care to cheaper preventative and early care, which is a lot less labor intensive. If you treat something early or prevent it, you can do it with nurse practitioners for very little money. If you wait until it turns into a health emergency, you are going to spend a lot of money on expensive specialists, and have a worse outcome. Like I said, there is a very good reason countries with UHC spend a lot less on health care and get better outcomes.

That accounts for some of the difference. The largest reasons are duplication of resources due to population density and costs of regulations, one of which I just mentioned. Spending five to save two is something we're familiar with.

 

[Hayabusa Rider]

Are you sure? I'm not blaming professional 100% - These countries don't have the layers either. Half HC are skimmers off the top. Insurance, Paperwork companies, distributors etc. - but there are no 2-5 million dollar a year surgeons in those countries like here. My brother owns pharmacies and makes almost 7 figures too. The margins are outrageous, I've seen them. Compared to say selling booze which I do.

I make em sick he fixes em

Yep. The Big Two I posted above. Want to drive your health care provider friends into a tizzy? Say just two words- "prior authorization".

 

[theeedude]

That accounts for some of the difference. The largest reasons are duplication of resources due to population density and costs of regulations, one of which I just mentioned. Abandons five to save two is something we're familiar with.

Replication of resources due to population density would imply more physicians and hospital beds per capita, the facts don't support that argument.

 

[Zebo]

Yep. The Big Two I posted above. Want to drive your health care provider friends into a tizzy? Say just two words- "prior authorization".

That's why he loves his oxycotin cash patients so much. I think he sells 160 for $320 now and cost is ~$60. Harder to get these days for independents but pays all the bills. He delivers ( well has a boy that does)

 

[Hayabusa Rider]

Replication of resources due to population density would imply more physicians and hospital beds per capita, the facts don't support that argument.

Not really. I'm talking infrastructure. Because people live in more rural areas you'll not be able to deny them modern treatments. Small hospitals servicing relatively few need most of you'd find in a city.

 

[pcgeek11]

Wow. A lot of lefty masturbation going on in this thread. How about the 1.76 Trillion cost.

 

[Fern]

Quietly, Obamacare is doing something even more ambitious than insurance expansion

Perhaps I'm reading it or wrong, misunderstanding you.

You seem to think this is some system wide change.

What I see is a change to Medicare billing only.

It my be a good change, but to say "that's getting at pretty much every major issue I've read about the U.S. health system" seems quite a stretch to me since it doesn't affect the majority us because we aren't on Medicare.

Fern

 

[fskimospy]

Wow. A lot of lefty masturbation going on in this thread. How about the 1.76 Trillion cost.

And what about the even better than expected deficit reduction!