Politics debate continued from multiculturalism thread

[Dauphin]

Originally posted by Starchild
GP consultation = Free
prescpription = £6.50 flat fee
specialist consultation = Free
thorough checkup = Free
blood test + various other tests = Free
course of vaccinations = Free
Band 2 Dentist (checkup, consultation, fillings and cleaning) = £42 flat fee

For everything else there's Mastercard.

[Nubclear]

blood test + various other tests = Free

Wow. I was ill once and the doctor ordered such tests on me, and it cost me $400.

[KrazyHorse]

It's easy to show why a large base of fully- or almost-fully insured clients runs up the cost of health care.

The US system is schizophrenic. Those with insurance consume inordinate amounts of health care (particularly high-cost health care when low-cost alternatives would suffice). This drives up the cost of insurance so that it becomes relatively unaffordable for a large number of people. It does so in two ways: firstly, insured individuals must be assumed to have greater demand for medical resources than they reasonably need, meaning that insurance companies pay for more resources. Secondly, the large number of insured individuals drives up the overall market cost of these resources so that even individuals who self-insure bear a part of this burden.

In return, the US system delivers little to no marginal benefit even to well-insured individuals above what the single-payer health system could provide. Doctors under the single-payer system manage their resources to provide the greatest possible level of service to the entire community. This efficiently distributes resources to those who need them most.

[GePap]

Originally posted by Ned
Also, can you simply call up and get a doctor's appointment any time you want it? I doubt it.

Except that when you get there, if you don't have insurance, the doctor won't see you.

[Lord Avalon]

Originally posted by KrazyHorse
It's easy to show why a large base of fully- or almost-fully insured clients runs up the cost of health care.

The US system is schizophrenic. Those with insurance consume inordinate amounts of health care (particularly high-cost health care when low-cost alternatives would suffice). This drives up the cost of insurance so that it becomes relatively unaffordable for a large number of people. It does so in two ways: firstly, insured individuals must be assumed to have greater demand for medical resources than they reasonably need, meaning that insurance companies pay for more resources. Secondly, the large number of insured individuals drives up the overall market cost of these resources so that even individuals who self-insure bear a part of this burden.

In return, the US system delivers little to no marginal benefit even to well-insured individuals above what the single-payer health system could provide. Doctors under the single-payer system manage their resources to provide the greatest possible level of service to the entire community. This efficiently distributes resources to those who need them most.

I don't entirely agree with you. Why would you assume the insured have greater demand for resources than what they need? Uninsured people also drive up the cost of health care, because they don't get preventative check ups, and then go to the ER when they're sick.

Actually, I think in the US it's easier for the insured to see specialists more easily than elsewhere, so there's more than marginal benefit there (at least to those getting that health care). Of course I can certainly see the point of using resources to provide basic health care for everybody, but what happens when those resources run out?

[GePap]

Originally posted by Lord Avalon

I don't entirely agree with you. Why would you assume the insured have greater demand for resources than what they need? Uninsured people also drive up the cost of health care, because they don't get preventative check ups, and then go to the ER when they're sick.

Actually, I think in the US it's easier for the insured to see specialists more easily than elsewhere, so there's more than marginal benefit there (at least to those getting that health care). Of course I can certainly see the point of using resources to provide basic health care for everybody, but what happens when those resources run out?

Why would they run out?

Health crae should be primarily about disease prevention, not disease maintenance or treatment. Its is simply cheaper to ensure that people can stay healthy, and the US system in particulalrly does not do this, not that any current health system is really set up with disease prevention as a main goal.

As KH pointed out, the European system is cheaper anyways.

[Lord Avalon]

Originally posted by GePap

Why would they run out?

Well, if say the government is running health care, they budget x dollars for the year. Can you not imagine x dollars being used before the year is up?

Health crae should be primarily about disease prevention, not disease maintenance or treatment. Its is simply cheaper to ensure that people can stay healthy, and the US system in particulalrly does not do this, not that any current health system is really set up with disease prevention as a main goal.

As KH pointed out, the European system is cheaper anyways.

An ounce of prevention is worth a pound of cure.

[Drogue]

Originally posted by Ned
Also, can you simply call up and get a doctor's appointment any time you want it? I doubt it.

Yes. I did it last term, got an appointment inside 20 minutes. But then I have the best doctors in the world - it was sort of out of hours, and so he said he'd stay in an extra half an hour Usually it takes a couple of days though, a week tops, perhaps, as others have said.

Originally posted by Lord Avalon
I don't entirely agree with you. Why would you assume the insured have greater demand for resources than what they need?

We don't need to ask why, we have evidence to show that they do. But the why seems quite obvious to me: doctors have an incentive to overprescribe, as they make money on the prescription, and you, the other person who chooses, doesn't pay for it. It's an externality, the person who pays for it (insurance company) doesn't make the decision to consume or not. KH is *exactly* right.

Lots of times there are more cost-effective alternatives than what is done. This will only get worse and more and more expensive proceedures are invented.

Originally posted by Lord Avalon
Actually, I think in the US it's easier for the insured to see specialists more easily than elsewhere, so there's more than marginal benefit there (at least to those getting that health care). Of course I can certainly see the point of using resources to provide basic health care for everybody, but what happens when those resources run out?

They don't. But more importantly, it costs less, and they still don't.

[Drogue]

Originally posted by Lord Avalon
Well, if say the government is running health care, they budget x dollars for the year. Can you not imagine x dollars being used before the year is up?

It would be such a vote-loser to decide part-way through the year that they couldn't offer treatment, so the budget would go up. Similar to the Iraq war But as said, it's still cheaper, even when it goes overbudget.

[Lord Avalon]

Originally posted by Drogue
We don't need to ask why, we have evidence to show that they do. But the why seems quite obvious to me: doctors have an incentive to overprescribe, as they make money on the prescription, and you, the other person who chooses, doesn't pay for it. It's an externality, the person who pays for it (insurance company) doesn't make the decision to consume or not. KH is *exactly* right.

Lots of times there are more cost-effective alternatives than what is done. This will only get worse and more and more expensive proceedures are invented.

Since when do doctors make money on the prescription? (Unless they own stock in the company which makes the drug, or are getting kickbacks, etc.) I go to a pharmacy to get prescriptions filled. It's not associated with my doctor.

And actually, I have a co-pay on my prescription drugs, and my insurance company has a drug formulary, so depending on what the level of coverage is, I have a low co-pay for generics, more for non-generics (and this past year it went up from $25 to up to 50% of the cost), and there might be drugs not covered at all, for which, if I decided to take it, I would have to pay the whole cost.

[Starchild]

Originally posted by Lord Avalon

Since when do doctors make money on the prescription? (Unless they own stock in the company which makes the drug, or are getting kickbacks, etc.) I go to a pharmacy to get prescriptions filled. It's not associated with my doctor.

And actually, I have a co-pay on my prescription drugs, and my insurance company has a drug formulary, so depending on what the level of coverage is, I have a low co-pay for generics, more for non-generics (and this past year it went up from $25 to up to 50% of the cost), and there might be drugs not covered at all, for which, if I decided to take it, I would have to pay the whole cost.

$25 - 50% of the total costs? Any prescription I get in the UK costs me £6.50 ($13).

[Drogue]

Originally posted by Lord Avalon
Since when do doctors make money on the prescription? (Unless they own stock in the company which makes the drug, or are getting kickbacks, etc.) I go to a pharmacy to get prescriptions filled. It's not associated with my doctor.

Doctors get paid referrals. Lots of money is spent by drug companies lobbying doctors, and most have incentive programmes for prescriptions. But I was more referring to the whole treatment process - tests "just to be safe", procedures that aren't strictly necessary, etc.

Originally posted by Lord Avalon
And actually, I have a co-pay on my prescription drugs, and my insurance company has a drug formulary, so depending on what the level of coverage is, I have a low co-pay for generics, more for non-generics (and this past year it went up from $25 to up to 50% of the cost), and there might be drugs not covered at all, for which, if I decided to take it, I would have to pay the whole cost.

These are all ways insurance can be made to closer resemble an efficient outcome. However, even theoretically, it is impossible for there to be any completely efficient insurance system for anything unless insurance is compulsory. Contacts and excesses help, but they don't make insurance totally efficient.

[KrazyHorse]

Why would you assume the insured have greater demand for resources than what they need?

I don't assume it. It's been shown in a number of different studies that individuals who don't have to bear a significant fraction of the cost of health care overconsume on quality.

[KrazyHorse]

Of course I can certainly see the point of using resources to provide basic health care for everybody, but what happens when those resources run out?

The point is to manage your resources effectively. Under the single-payer system doctors don't prescribe MRIs when CATs will suffice. Under the insurance driven market of the US system neither doctor nor patient have an incentive to find economical methods to treat illness. Only the HMO scheme at all attempts to do this, and it fails for a number of reasons.

[KrazyHorse]

Originally posted by Lord Avalon

Well, if say the government is running health care, they budget x dollars for the year. Can you not imagine x dollars being used before the year is up?

Wow. You must think that people who run health care systems are absolutely retarded. Dozens of countries manage it without there being a dead period of a month at the end of the year when nobody can see a doctor or go to a hospital.