Let's make health care more affordable for citizens by making it more expensive.

[Velociryx]

Kirnwaffen,

You have the gist of it.

And while there may be SOME truth to the thinking, I'd imagine there's a whole lot of "low hanging fruit" we could harvest to bring down medical costs without even paying this one any mind at all.

-=Vel=-

[Kidlicious]

Another point is that the health insurance market is very uncompetitive. Even if you broke up the industry that's not going to make the healthcare industry more competitive, which is where most of the costs are.

[Ell_man]

Originally posted by Ramo
But the argument relies on the assumption that people are generally getting too much health care, and instead they should have low deductible, high co-pay health care. Which actually deters people from getting stuff like preventative care, which drastically lowers costs long-term. In other words, McCain believes what an individual considers rational (I'm not going to get sick, so I'll get crappy insurance + a 42" tv) is necessarily beneficial to society.

I think this is the crux of the difference between the 2 points of view. I think people won't systematically underestimate or overestimate the probabilities, while you think that people will underestimate probabilities . The low deductible, high co-pay health care is actually a feature, not a bug, because it pushes people to get more health care(and preventative care) when they otherwise wouldn't. Whereas my interpretation says that people buying too much health care is the problem. People are not getting too little preventative care, they're getting too much.

Obviously they can't both be right.

[Kidlicious]

The problem isn't with the consumer. It's with the insurance companies. The insurance companies are the ones who add on the costs by adding benefits. It's technology which is driving this.

So in a way there is too much health care, but it's not preventative care that there is too much of. McCain seems to think that it is.

IMO the only solution is national health care, because that's the only way to control the cost driver, implementation of technology into the system.

[Jon Miller]

Considering most health problems in the US at least could be prevented, I think that your interpretation is wrong.

JM

[Ramo]

I think people won't systematically underestimate or overestimate the probabilities

On what basis do you believe that? What about human nature makes you believe that we underestimate long term costs. Have you been paying attention at all to the financial markets?

I know that I don't get enough preventative care because my insurance is crappy. Even though I'm cognizant about the implications here, it's really hard to justify going to the doctor or dentist to myself. I'm sure it's the same for everyone else.

[Patroklos]

You do realize you just asked him what basis he believed that and then provided no such creditable basis yourself right?

The article makes perfect sense, and nobody has yet to claim such a change would be the end all be all of health care reform.

[Ramo]

You do realize you just asked him what basis he believed that and then provided no such creditable basis yourself right?

No, I did. See the next sentence.

I said that because it's self-evident. I could find the data later, but I think the collapse of the economy is a pretty good representation of my point here.

[Jon Miller]

No one I know gets too much preventative care. Most get far too little.

JM

[Kirnwaffen]

I think the real root of the problem is that doctors have competing interests. On the one hand, they want to provide the best care possible. On the other, their practice has to survive economically. Reimbursement right now is based largely on procedures, so what you get is the most profitable, relevant procedure that a doctor can justify. So, if you want to lower healthcare costs, you have to do something about the drivers.

[DirtyMartini]

Originally posted by Kirnwaffen


So, let me see if I understand this: People go get unneccesary healthcare because they're not paying for it, which drives up the cost? That's actually ridiciulous.

this is entirely true -- my health plan used to have no copay for ER visits. Guess what? the ER was overutilized. Guess what? an ER visit for a given problem is much more expensive for the system than a normal office visit for the same problem. this is but one example.

[Blaupanzer]

Give your insurance company a government credit for $5000, so they can charge you $12,000, then tax the $7000 difference IF your employer pays your share and call the whole thing a plan. Can you tell who owns seven houses and has one of the cheap ones up for sale at $1.6 million? The old geezer has no idea how bad an idea this is!

[Jon Miller]

Originally posted by DirtyMartini


this is entirely true -- my health plan used to have no copay for ER visits. Guess what? the ER was overutilized. Guess what? an ER visit for a given problem is much more expensive for the system than a normal office visit for the same problem. this is but one example.

Given that a lot of people I know don't have a normal doctor (Because they don't have insurance), they don't have any choice other than wait until it becomes ER worthy. Because the ER can't turn them away.

This is a much more likely reason for ER to be so expensive.

JM

[Kirnwaffen]

this is entirely true -- my health plan used to have no copay for ER visits. Guess what? the ER was overutilized. Guess what? an ER visit for a given problem is much more expensive for the system than a normal office visit for the same problem. this is but one example.

That's a terrible example. Most people seek to avoid the ER because of the sheer inconvenience of it. Plus, it ignores the fact that the reason the ER is actually overutilized is because they cannot deny you care if you can't pay. It also ignores the fact that ER visits are reduced (right along with costs) when preventative care is provided and utilized.

[Zkribbler]

What no one's pointed out yet is that McCain's proposal would effectively do away with group insurance, which is the most efficient way to buy insurance.