Bow Before the Limbaugh!

[Dinner]

Will this do?

ACK!

AWESOME!

[Tuberski]

Avatar size.

ACK!

[Dinner]

I resized it myself.

Jabba the Rush for the win!

[Tuberski]

I was called a liberal yesterday, because I told a guy he needs to watch something besides Fox News.

"Liberal" is a swear word in these parts.

ACK!

[The Mad Monk]

IIRC, the founding fathers were equally wary of monied interests. I think today's corporate America would scare the **** out of them.

Our current healthcare system is a mess... and is corporate in structure. It's not like HMOs don't currently tell people what care they can and cannot have. I count myself lucky to have a PPO medical plan.

So I don't really understand the fear of the government controlling those things as opposed to a corporation.

-Arrian

In answer to the other post, yes, tort reform. Reductions in malpractice and other insurance would follow.

As for the HMOs, I would much prefer the current system, where HMOs must still compete with each other and other forms of insurance (your PPO, for example). With that system, the companies must provide a certain level of service, or they will lose customers to other entities; it's not perfect, but it is a system where efficiencies are sought out without being overly onerous.

With a government based system, there is no competition, and nobody to appeal to. Priorities will be based not on your interests (yes, the current system does respond to your interests, or PPOs would not exist), but on what will garner the politicians the most contributions or votes in the next election.

Without which we'd really have very limited health insurance, and people would die/go bankrupt when they got sick just like in the good old days, and by good I mean

So instead we'll give everyone all the care possible as long as possible, and then we'll all go bankrupt. Right?



Of course, that's not going to happen. There will be limits to treatments, in the interest of efficiency; there will be waiting lists, there will be age cut-offs for treatments -- because it's the peoples' money, and there's no point in giving a hip replacement to that 78 year old, because she's not going to use for more than a year or two, and those things are expensive.

I am going to die one day, and if I die because I could not afford a treatment, that really is my own tough luck. I am not going to deny it to someone better off in the interest of "fairness". Everbody dies. We are livng much longer than we used to, and we require more to get there, and we want to keep holding on as long as possible, understandably. That demand, more than anything, is what is driving costs up.

There is a limit to what can be done; I would rather that the market reward those who prepare, than it be handed out arbitrarily by the government.

[DaShi]

In answer to the other post, yes, tort reform. Reductions in malpractice and other insurance would follow.

As for the HMOs, I would much prefer the current system, where HMOs must still compete with each other and other forms of insurance (your PPO, for example). With that system, the companies must provide a certain level of service, or they will lose customers to other entities; it's not perfect, but it is a system where efficiencies are sought out without being overly onerous.

This is what people hoped HMOs would do. Turns out they won't or can't.

With a government based system, there is no competition, and nobody to appeal to. Priorities will be based not on your interests (yes, the current system does respond to your interests, or PPOs would not exist), but on what will garner the politicians the most contributions or votes in the next election.

A government run system won't be run by politicians. Not even medicare is.

Of course, that's not going to happen. There will be limits to treatments, in the interest of efficiency; there will be waiting lists, there will be age cut-offs for treatments -- because it's the peoples' money, and there's no point in giving a hip replacement to that 78 year old, because she's not going to use for more than a year or two, and those things are expensive.

Seriously, do you know how the medical payment system works?

I am going to die one day, and if I die because I could not afford a treatment, that really is my own tough luck. I am not going to deny it to someone better off in the interest of "fairness". Everbody dies. We are livng much longer than we used to, and we require more to get there, and we want to keep holding on as long as possible, understandably. That demand, more than anything, is what is driving costs up.

Yes, but what you want isn't all that's important. Other people think differently. I'll never understand this ego-centric reasoning.

[Dinner]

It's not just demand (though demand is going up as the population ages) but it is also other things. For instance drug prices, we don't have economies of scale while every other country does so they pay lower prices for the same drugs compared to us. For instance a country like Germany has one central purchaser buy medication for all 82 million people in the country which means they have the market power to squeeze every last penny out of the supply chain much like how Walmart can secure lower prices then small mom & pop stores. The US's market is highly fragmented which we don't get those economies of scale and thus we pay more.

[Felch]

Nope. The first HMO was Kaiser Permanente, a creation of Kaiser Steel in Fontana California.

I heard that it was created to allow him to give employees a non-wage benefit. Because the government was regulating workers' wages, Kaiser had to come up with something else to attract and retain workers.

[Dr Strangelove]

In answer to the other post, yes, tort reform. Reductions in malpractice and other insurance would follow.

As for the HMOs, I would much prefer the current system, where HMOs must still compete with each other and other forms of insurance (your PPO, for example). With that system, the companies must provide a certain level of service, or they will lose customers to other entities; it's not perfect, but it is a system where efficiencies are sought out without being overly onerous.

My silly state farmed out most of its Medicaid service to HMOs last year. It hasn't resulted in better service, instead I now have to deal with 3 bureaucracies instead of one. I'm spending more time on the phone obtaining authorizations for drugs and services. The way I see it they make their money by stealing my precious time. If I were a fracking lawyer I could bill them for that phone time.

With a government based system, there is no competition, and nobody to appeal to. Priorities will be based not on your interests (yes, the current system does respond to your interests, or PPOs would not exist), but on what will garner the politicians the most contributions or votes in the next election.

See above, only it turns out that "competition" in this case does not result in better service, but in a multiplication of useles bureaucracy. You evidently have not spent an appreciable amount of time dealing with insurance companies. In the US at least people dealing with a government agency have certain rights that they do not have when dealing with a provate company.

So instead we'll give everyone all the care possible as long as possible, and then we'll all go bankrupt. Right?



Of course, that's not going to happen. There will be limits to treatments, in the interest of efficiency; there will be waiting lists, there will be age cut-offs for treatments -- because it's the peoples' money, and there's no point in giving a hip replacement to that 78 year old, because she's not going to use for more than a year or two, and those things are expensive.

I am going to die one day, and if I die because I could not afford a treatment, that really is my own tough luck. I am not going to deny it to someone better off in the interest of "fairness". Everbody dies. We are livng much longer than we used to, and we require more to get there, and we want to keep holding on as long as possible, understandably. That demand, more than anything, is what is driving costs up.

How about your 5 year old son? Would it be OK for him to forgo leukemia treatment so that someone "better off" can have one? Had he just as well die off rather than drive up costs?
This actually happened in this area a few years ago. The sickening thing is that the institution that denied his care was a state university. In fact, thanks to the privatization of Medicaid even people whose care is a mandate of the state get turned away from the state university medical center. The university doesn't take their HMO insurance.

There is a limit to what can be done; I would rather that the market reward those who prepare, than it be handed out arbitrarily by the government.

Wouldn't it be cool if your Dad had dumped your Mom and three siblings when you were 4 and then you came down with a fatal illness. Imagine how cool that would be.

Here's something really cool for you. Imagine how cool it would be if when you were a kid some televangelist told people that they ought to resist integration by closing down their county school systems. Imagine if you were one of the kids living in one of the counties which did so - so you didn't get an education. When yopu grew up you managed to get a job in a textile factory, but after about 15 years they took your pension fund in order to continue operating, then the next year moved your job to to Taiwan. You found another job at minimum wage with no insurance - after all you have no education. Then you got sick.
Oh, and they just named a highway after the televangelist who stold your education.

[Arrian]

TMM, I honestly do not believe that tort reform will have much impact on the price of healthcare. Key word being much. Sure, malpractice premiums may (should) go down. That, in turn, should, err, trickle down. But I don't think that's even close to the main driver here.

The main driver, as you note, is essentially unlimited demand. People don't want to die. We can't do all that much about that. We can cut out the layers of bureacracy that Dr. Strangelove is talking about. It's a fact that other systems cost their societies far, far less than ours costs us, and those systems cover everyone.

Other countries spend significantly less than we do. Why can't we design a system that falls inbetween? Something that costs us more than the Canadian and British systems cost them, but less than we pay now?

I also don't see why the rich should be disallowed from paying extra for extra care. The system I want is about providing good basic care for everyone. When it comes to expensive treatments for serious stuff, then, much like under an HMO or PPO plan now, the % paid by the insurance would start to drop. The rich would still have some advantages, but it would be better than it is now.

-Arrian

[Victor Galis]

So instead we'll give everyone all the care possible as long as possible, and then we'll all go bankrupt. Right?

You get an immediate savings by eliminating the cost of screening people out and the profits of the HMOs (since the government is now playing that role). Then if you fail to have tort reform or use your scale to obtain cost savings, that's a flaw in the implementation not necessarily inherent in government run healthcare.

[Whoha]

For instance a country like Germany has one central purchaser buy medication for all 82 million people in the country which means they have the market power to squeeze every last penny out of the supply chain much like how Walmart can secure lower prices then small mom & pop stores.

What incentive is there to innovate if every last penny is squeezed out?

[Ramo]

The NIH (and NSF, to a lesser extent). That's where funding for basic research in biotech comes from.

There's absolutely no reason to allow the drug companies to continue looting this country.

[Ben Kenobi]

I was called a liberal yesterday, because I told a guy he needs to watch something besides Fox News.

"Liberal" is a swear word in these parts.

Did you tell him thanks? You are a liberal. Don't see what's wrong with being one.

[DinoDoc]

The NIH (and NSF, to a lesser extent). That's where funding for basic research in biotech comes from.

Considering the fact that as of 2003 the NIH sponsored only 28 percent of biomedical research with industry shouldering the lion's share of the burden, I fail to see the basis for this and the statement regarding the looting of the country by the medical industry comes from. If you have stats that show differently, I would be interested in taking a look at them.

http://www.eurekalert.org/pub_releases/2005-09/jaaj-ffb091505.php