Thought Bubble - Health Care Overhaul

[Stunt]

Not to flog a dead horse, but an interesting video clip...

Health Care Though Bubble

I agree that healthcare is far too expensive in the US and impacts productivity; the issue cannot be allowed to fizzle. I see many companies attracted to countries where health services are paid for by the government through personal income tax. I however think the government is terrible at administering any kind of good or service. Somehow there has to be a way to get the economies of scale and take the profit out of inevitable risk but also not allow an unaccountable institution to create new inefficiencies.

 

[Turin39789]

That seemed reasonable.

 

[dullard]

I'll beat this dead horse:

1) Government should pay to build more medical schools (and more residencies). More schools = more doctors = more competition = better care at a cheaper price.

2) Government should limit medical overuse. Get rid of the right of admittance to any emergency room for any reason. Get rid of the forced visits to doctors when a nurse or a pharmacist should be able to do the same thing (ie to refill a non-dangerous, non-dosage-changing drug prescription). Get rid of incentives to perform more services regardless of the lack of benefit to the society.

3) Goverment should limit medical malpractice lawsuits. This is a small part of the overall medical bill, but it needs to be done.

4) On the flip side to #3, government needs to limit legal malpractice. So what if a customer comes in and demands a drug (as seen on TV!) the doctor should be held financially and legally responsible for prescribing unneeded drugs.

5) Government should make ALL forms of health care be at least partially paid by the consumer. As it is now, we have a use-it or lose-it mentality. I get my teeth checked twice as often as I need, since it is virtually free to me. At least make it a nominal fee to help get consumers to only use health care when they need health care.

6) Government should take the responsibility for health care away from employers. Honestly, not many businesses know much about health care yet your incompetant manager is the one who makes the biggest health care decisions for you by choosing your insurance plan options. Let businesses focus on being businesses.

7) Goverment should help those who otherwise can't get help (too poor or pre-existing condition). Uninsured people are one of the biggest causes of bankruptcies (if not the #1 cause). This costs us all as we bail them out.

8) I believe #6 and #7 should come through a government tax credit to individuals that matches a high-deductable insurance plan cost and through dropping the business deduction for insurance. This way, any legal US citizen who files taxes can buy whatever insurance they want. This way, government makes no health care decisions AT ALL. This way, illegals aren't covered. This way tax cheats aren't covered. This way, everyone else is covered.

In return, society needs to end the mindset of "extend life at all costs". We don't need to put our 105 year old grandpa through major surgery just so he can live 3 weeks longer (three weeks in pain from the surgery, of course).

 

[0marTheZealot]

Originally posted by: dullard
5) Government should make ALL forms of health care be at least partially paid by the consumer. As it is now, we have a use-it or lose-it mentality. I get my teeth checked twice as often as I need, since it is virtually free to me. At least make it a nominal fee to help get consumers to only use health care when they need health care.

Medical costs are exorbitant. You can spend 6 digits just diagnosing a difficult to identify disease, never mind the treatments that follow the diagnosis. A round of chemotherapy can cost 100,000+ dollars. Passing even a small percentage of this cost off to the consumer will ruin them.

 

[rudder]

the healthcare bill won't pass because republicans are assholes.

 

[Auryg]

Originally posted by: dullard

2) Government should limit medical overuse. Get rid of the right of admittance to any emergency room for any reason. Get rid of the forced visits to doctors when a nurse or a pharmacist should be able to do the same thing (ie to refill a non-dangerous, non-dosage-changing drug prescription). Get rid of incentives to perform more services regardless of the lack of benefit to the society.

I knew a man who died from an infection in his head. To him, it was just a really bad headache. He kept on going back to his dentist (he had some light surgery done before which is what started it) who just gave him pain pills, again and again. The infection finally burst into his brain and he died instantly. Unfortunately, something that seems small to a nurse, or even a doctor, can be something quite serious.

As for that part against needing to "extend life at all costs" - lets say you the same when you're on the verge of death. My great uncle has cancer over his whole body right now, and basically has no chance to live. The doctors told him this, but he's still going through with treatment. Can you blame him?

 

[Phokus]

Originally posted by: rudder
the healthcare bill won't pass because republicans are assholes.

On this forum, i notice that conservatives fall into two camps:

1) Those who want to keep the status quo ('keep feeding the pig' from that video)

and

2) Those that say they want reform, say they don't want any socialism, yet either offer no real substantive solutions.

In summary: conservatives are going to doom this nation with their stupidity.

 

[Tequila]

Here's the real problem. Those on the left want a public option but don't care what it is and how much it will cost just as long as it passes. Those on the right want reform especially tort reform(which I agree with) and co-ops(somewhat agree with) but don't think that healthcare is a right and are ok with CEOS making millions while americans go uninsured.

For those of us few in the middle who want an intelligent debate we can't get it. There's too much noise on both sides. All I hear from the left is how the right is a bunch of anti-american, Fox-news-backed-tea-party aholes and how the right is only concered about Death Panels on a nightly basis. All I hear from the right is how the left is a bunch of nazi, commy lovers and the constant overuse of the word socialism when they don't even realize this country is socialized in many ways. You just can't get past all this B.S and it really pisses me off.

For instance, these are the issues I want to see discussed.

How about screw a new public option and just allow those who aren't covered to opt in to Medicare as suggested by Thom Hartmann? We already have 4 systems in this country, we don't need another fricken one. We have (1) employer based (2) Medicare for 65+ (3) VA for military vets (4) a NHS system for native americans. The typical lefty wants yet another system with brand new loop holes, new potential fraud abuse and more bloat. Why not clean up the loop holes and fraud in Medicare and allow anyone to opt in? This is the natural way of the party in power. They want new and more governement not to clean up what already exists. DHS and several other new departments under Bush pisses me off just as much. We need a lean and functional government to balance the coprorate world.

Or how about we take baby steps toward a system like Switzerland and or Germany where insurance companies are non profit and still compete for members. The reason it was easy to transition to the current system in Switerland was because most of their insurers were already non profit. We could start out with funding co-ops and slowly make our way there but I don't think the dems are up for that.

Or just screw it and scrap all the systems and just go single payer? Well if we could do what Taiwan did where they don't have a gateway, you can go see a specialist as youl ike then I'm all for it but I just don't see it happening in this country at this time.

This is the problem with Obama and the democrats and probably why the current bill will fail which I honestly hope it does. They just want to cram their version down our throats and a lot of people fought back, and while some of them are loud and obnoxious not all of them were. I saw some very reasonable questions raised by the right only to be drowned out by the left as anti-american.

Oh and while we are at, how about we look at why healthcare is 16% of GDP when it was only 5% back in 1960. We need tort reform but I'm willing to bet you the rising costs are also due to a very disturbingly out of shape, obese population. If you don't lick those problems then costs are still going to rise no matter what system is in place.

Ok, now I really need a drink!

 

[dammitgibs]

Originally posted by: Phokus

Originally posted by: rudder
the healthcare bill won't pass because republicans are assholes.

On this forum, i notice that conservatives fall into two camps:

1) Those who want to keep the status quo ('keep feeding the pig' from that video)

and

2) Those that say they want reform, say they don't want any socialism, yet either offer no real substantive solutions.

In summary: conservatives are going to doom this nation with their stupidity.

Can someone show me where I can find all these people that want to keep the status quo? I keep hearing about these people that think the system is fine the way it is but I can't find any of them to ask them why they think the system is fine? I've never heard a liberal or conservative say "don't change a thing" so please show me where to find them.

 

[Slew Foot]

Originally posted by: dullard
I'll beat this dead horse:

1) Government should pay to build more medical schools (and more residencies). More schools = more doctors = more competition = better care at a cheaper price.

That assumes that physician reimbursement is the cause of high costs. As it stands, physicians only receive about 5% of the total health care outlay in the country. Even if they all worked for free, your end up paying an insurance premium of$950/mo instead of $1000(typical cost for a gold plated family coverage). And then youd have medical care of the quality of people who arent getting paid.

 

[Mursilis]

Originally posted by: rudder
the healthcare bill won't pass because republicans are assholes.

And the Republicans in charge of Congress and the White House are definitely going to stop it!

:roll: Might as well blame the Whig Party! The Dems run the show - if they want health-care reform, all they have to do is pass it. But I'm guessing they don't - they want to keep the issue around to win future votes.

 

[dullard]

Originally posted by: Slew Foot
That assumes that physician reimbursement is the cause of high costs. As it stands, physicians only receive about 5% of the total health care outlay in the country. Even if they all worked for free, your end up paying an insurance premium of$950/mo instead of $1000(typical cost for a gold plated family coverage). And then youd have medical care of the quality of people who arent getting paid.

Ok, Slew Foot, do you care to back up those numbers?

I did a little searching. This appears to be from a farily unbiased study. 33% of the health care outlay goes to physician services. Of course inpatient, outpatient, and other medical service costs also at least partly go to doctors as well. But, this is offset by the fact that not every dollar that goes to a clinic will go to the doctors. A good chunk will go elsewhere. Another number from another source: 33.7% goes to physician services. Of course, physicians themselves did a similar study showing slightly less goes to physicians. But, it wasn't that much less.

Unfortunately, that is as fine of a detail that I have. With 73% of funds going to clinics and hospitals, you claim that just 5% that go to the doctors. That seems a bit hard to believe. So, do you have a link that shows that doctors get only 5%?

That said, even saving 1% is a massive saving. If your 5% number is true and if more competition dropped overall payments to doctors by 20%, we'd save over $20 BILLION.

 

[dullard]

Stunt,

While I was looking hard to find the amount of money that goes to physicians, I ran across some other interesting numbers. Federal, state, and local goverment directly pay for 45% of all health care costs. But, since the goverment gives deductions for insurance premiums, and individual deductions for high medical costs, the goverment share is actually over 60%. That really brings home the Thought Bubble's point: We already have socialized medicine.

The whole debate comes down to shifting that last 40% from employers and individuals to the government. Sure, that'll cost taxpayers money. But it'll save employers and individuals money as well. We're actually arguing over the small piece of the pie. I never realized that before.

 

[paperfist]

Originally posted by: dullard
I'll beat this dead horse:

1) Government should pay to build more medical schools (and more residencies). More schools = more doctors = more competition = better care at a cheaper price.

One is only part of the problem, drugs is the other; Pfizer Settles Unlawful Marketing Case for $2.3 Billion. So the government should start doing the job we pay them for and keep companies in check.

 

[JS80]

Originally posted by: Stunt
Not to flog a dead horse, but an interesting video clip...

Health Care Though Bubble

I agree that healthcare is far too expensive in the US and impacts productivity; the issue cannot be allowed to fizzle. I see many companies attracted to countries where health services are paid for by the government through personal income tax. I however think the government is terrible at administering any kind of good or service. Somehow there has to be a way to get the economies of scale and take the profit out of inevitable risk but also not allow an unaccountable institution to create new inefficiencies.

bipartisan my ass. left wing video under the guise of "factchecking" or bipartisan.

 

[JS80]

Originally posted by: Slew Foot

Originally posted by: dullard
I'll beat this dead horse:

1) Government should pay to build more medical schools (and more residencies). More schools = more doctors = more competition = better care at a cheaper price.

That assumes that physician reimbursement is the cause of high costs. As it stands, physicians only receive about 5% of the total health care outlay in the country. Even if they all worked for free, your end up paying an insurance premium of$950/mo instead of $1000(typical cost for a gold plated family coverage). And then youd have medical care of the quality of people who arent getting paid.

I think the theory is more medical professionals = more innovation = drives down costs

 

[Hayabusa Rider]

Originally posted by: dullard

Originally posted by: Slew Foot
That assumes that physician reimbursement is the cause of high costs. As it stands, physicians only receive about 5% of the total health care outlay in the country. Even if they all worked for free, your end up paying an insurance premium of$950/mo instead of $1000(typical cost for a gold plated family coverage). And then youd have medical care of the quality of people who arent getting paid.

Ok, Slew Foot, do you care to back up those numbers?

I did a little searching. This appears to be from a farily unbiased study. 33% of the health care outlay goes to physician services. Of course inpatient, outpatient, and other medical service costs also at least partly go to doctors as well. But, this is offset by the fact that not every dollar that goes to a clinic will go to the doctors. A good chunk will go elsewhere. Another number from another source: 33.7% goes to physician services. Of course, physicians themselves did a similar study showing slightly less goes to physicians. But, it wasn't that much less.

Unfortunately, that is as fine of a detail that I have. With 73% of funds going to clinics and hospitals, you claim that just 5% that go to the doctors. That seems a bit hard to believe. So, do you have a link that shows that doctors get only 5%?

That said, even saving 1% is a massive saving. If your 5% number is true and if more competition dropped overall payments to doctors by 20%, we'd save over $20 BILLION.

Well let's see if they make that much.

Cost of American health care is roughly 2.2 trillion dollars.

Average physician income in the US is $228,000 before malpractice and other costs. Certainly many specialties earn more than that, but malpractice premiums in some areas can reach 300K per year.

Not bad eh? Go to school and in 4 years you are making over 200k a year!
Well no. If you are going to be a GP, that number is lower. Median income is a bit under $160,000.

Still not bad. Four years and then $160k.
Well no. Of that take around $15k out for malpractice unless you live in places like NY state, where you are talking around $35k.

Ok, so 4 years and $145k.
Well no. That's median. The beginning pay is typically closer to 120K. Call it $125,000. That's before the $15k, which is probably closer to $17K.

$125,000-$17,000 = $107,000.

After 4 years you are making $107,000. Nothing exciting, but not bad.
Well no. It isn't four years. It's 4 college, 4 medical school and three or four years or so in an intership program.

Eleven years, and $107K. That's 7 years income lost while your engineering buddies were making a living. By now the may have paid off their educational loans. Oh, speaking of paying for school- The average debt entering residency is $155K. That's after all the financial aid one can get.

Now how much do you think you can cut wages?