Healthcare reform

[StrangeSox]

And just who is it in these countries that can AFFORD to get private insurance? certainly not everyone. Sure, they have the same opportunity to purchase it, but then private insurance becomes a perk of the wealthy.

 

Yeah, sorta like purchasing health insurance on your own so that you actually have choice is a perk of the wealthy in this country.

[southsider2k5]

That cuts both ways, kap, with the horror stories of ZOMG! SOCIALIZED MEDICINE! in Europe and Canada.

 

Why haven't countries with actual single-payer systems seen the disappearance of private health care? Don't you think there's a big enough political opposition that there will always be a market for private insurance in this country?

 

And yeah, surprise, Obama isn't cramming a super Marxism policy down our throats like conservatives b****ed about for months now. The democrats aren't nearly as cohesive as the republicans and they love kowtowing to the mythical middle and cowering at the first signs of opposition. These health care proposals without a government option or co-op are not liberal in any way, yet its still portrayed as ZOMG! SOCIALISM!

 

Because the governmental officials still need somewhere decent to get their health care in those countries...

[southsider2k5]

 

Slower than everyone but Canada.

 

 

If we have the best health-care in the world, why is our mortality amenable to healthcare so high?

 

Also, the argument isn't over whether or not the actual health care is the problem. We certainly have excellent doctors and treatment facilities. The problem is that we pay more than anyone else in the world and 50 million of our citizens are without insurance, effectively meaning they are barred from anything but emergency services. It is an issue of access and affordability not quality of care.

 

That 50,000,000 number is crap. Also the idea that you could pile 50 million people into the system and people would somehow all get the "access" that you are infering.

[Balta1701]

That 50,000,000 number is crap. Also the idea that you could pile 50 million people into the system and people would somehow all get the "access" that you are infering.

As is the idea that you can't treat these people. As I keep saying, other countries have fewer doctors per capita than we already do and do just fine.

[Balta1701]

And just who is it in these countries that can AFFORD to get private insurance? certainly not everyone. Sure, they have the same opportunity to purchase it, but then private insurance becomes a perk of the wealthy.

There is nothing wrong with that. That's exactly the system we ought to have, frankly. Establish a baseline of coverage for everyone. You get sick, you get treated. Then, if people want to pay more for things above and beyond that...luxury waiting rooms or Hell, to get to the front of the line for cosmetic surgery or elective procedures, great. That's how the French and Germans both do their health care system, IIRC.

[southsider2k5]

As is the idea that you can't treat these people. As I keep saying, other countries have fewer doctors per capita than we already do and do just fine.

 

So why is it that there is no spare capacity anywhere?

[Balta1701]

So why is it that there is no spare capacity anywhere?

Because our system is designed in a way such that everyone makes more money the more they do. The more procedures a doctor orders, the more money they make. You guys like capitalism, you ought to understand that concept; if you make more money by ordering more care, you're going to order more care for people.

 

The British, IIRC, do something different. If you pay doctors on salary, even if they're making really, really good salaries, then you remove the economic incentive where it benefits a doctor to overtreat.

 

This points back directly to that test-case in El Paso TX we talked about a few times, where in McAllen TX, the doctors were ordering vastly more care for the same amount of tests as the city next door and were getting worse health care outcomes.

[kapkomet]

Because our system is designed in a way such that everyone makes more money the more they do. The more procedures a doctor orders, the more money they make. You guys like capitalism, you ought to understand that concept; if you make more money by ordering more care, you're going to order more care for people.

 

The British, IIRC, do something different. If you pay doctors on salary, even if they're making really, really good salaries, then you remove the economic incentive where it benefits a doctor to overtreat.

 

This points back directly to that test-case in El Paso TX we talked about a few times, where in McAllen TX, the doctors were ordering vastly more care for the same amount of tests as the city next door and were getting worse health care outcomes.

And I've been telling you the fallacies of this.

 

Different contracts. Different demographics - totally different. There's a totally different way of doing business in these two cities. One's all in cash.

 

They're certainly not "neighbors", they're 700 miles apart.

 

And all of a sudden, these "47 million" will make the rest of the US stop doing "all these tests". LMAO. Oh, wait, degradation of care, quality of care goes down... I thought that wasn't going to happen? This is again, double speak. Add people, quality stays the same... cut costs, add people. BS. It can't happen.

[NorthSideSox72]

Because our system is designed in a way such that everyone makes more money the more they do. The more procedures a doctor orders, the more money they make. You guys like capitalism, you ought to understand that concept; if you make more money by ordering more care, you're going to order more care for people.

 

The British, IIRC, do something different. If you pay doctors on salary, even if they're making really, really good salaries, then you remove the economic incentive where it benefits a doctor to overtreat.

 

This points back directly to that test-case in El Paso TX we talked about a few times, where in McAllen TX, the doctors were ordering vastly more care for the same amount of tests as the city next door and were getting worse health care outcomes.

You know, I don't agree with a lot of what you say on this topic, but I am intrigued by the idea of somehow creating a model where Doctor's salaries are flat regardless of procedures ordered or performed. I'm not sure how you'd do it, but, if you can find a way to make it work, I'd be all ears.

 

[Balta1701]

And all of a sudden, these "47 million" will make the rest of the US stop doing "all these tests". LMAO. Oh, wait, degradation of care, quality of care goes down... I thought that wasn't going to happen? This is again, double speak. Add people, quality stays the same... cut costs, add people. BS. It can't happen.

You're making several assumptions about the current system that even you disagree with if I phrase it in a different way. If I ask you if doctors were over-ordering tests to cover their arses in the event of a malpractice suit, you've made it clear that you 100% agree that is a major problem with the current system and a major reason why costs are out of control, thus you argue that malpractice reform (Yay says the right side of the Congressional chamber!) is one of the biggest keys to controlling costs. Thus, if I phrase things in a slightly different way, you're 100% willing to admit that overuse/overtreatment is a major problem in our system.

 

You can't have it both ways. If there's no over-utilization in the system, then banning all malpractice suits for all time won't have any impact in terms of cost control.

[BigSqwert]

You're making several assumptions about the current system that even you disagree with if I phrase it in a different way. If I ask you if doctors were over-ordering tests to cover their arses in the event of a malpractice suit, you've made it clear that you 100% agree that is a major problem with the current system and a major reason why costs are out of control, thus you argue that malpractice reform (Yay says the right side of the Congressional chamber!) is one of the biggest keys to controlling costs. Thus, if I phrase things in a slightly different way, you're 100% willing to admit that overuse/overtreatment is a major problem in our system.

 

You can't have it both ways. If there's no over-utilization in the system, then banning all malpractice suits for all time won't have any impact in terms of cost control.

 

And Boom goes the dynamite!

[bmags]

And just who is it in these countries that can AFFORD to get private insurance? certainly not everyone. Sure, they have the same opportunity to purchase it, but then private insurance becomes a perk of the wealthy.

 

sounds familiar

[BigSqwert]

sounds familiar

Doing my best southsideirish71 impersonation today...

 

[kapkomet]

You're making several assumptions about the current system that even you disagree with if I phrase it in a different way. If I ask you if doctors were over-ordering tests to cover their arses in the event of a malpractice suit, you've made it clear that you 100% agree that is a major problem with the current system and a major reason why costs are out of control, thus you argue that malpractice reform (Yay says the right side of the Congressional chamber!) is one of the biggest keys to controlling costs. Thus, if I phrase things in a slightly different way, you're 100% willing to admit that overuse/overtreatment is a major problem in our system.

 

You can't have it both ways. If there's no over-utilization in the system, then banning all malpractice suits for all time won't have any impact in terms of cost control.

The difference is you cherry pick crap - just like I supposedly just did - to create these fallacies that do not exist in the current system. The truth is, private companies, albiet absolutely imperfect, do a pretty damn good job. You want to talk about preventative medicine - our system has so many pharaceutical innovations that keep people from being more sick - all that will go by the wayside - it's proven in Europe and Canada.

 

Testing for CYA is different then testing for other things. Which, by the way, even though they're 700 miles away, they do exist within the same state. Again, different payor mix, different contract issues, etc. re: Texas. But that's ok, my argument sucks because by golly our system sucks and we need intervention by the government (I mean, who else would do it, these big bad EVIL corporations are just sticking your ass because it's fun, right?)./

 

[BigSqwert]

because by golly our system sucks and we need intervention by the government

That's what a majority of Americans are saying and hence the need for reform.

[Balta1701]

The difference is you cherry pick crap - just like I supposedly just did - to create these fallacies that do not exist in the current system. The truth is, private companies, albiet absolutely imperfect, do a pretty damn good job. You want to talk about preventative medicine - our system has so many pharaceutical innovations that keep people from being more sick - all that will go by the wayside - it's proven in Europe and Canada.

Now here's one actual argument that hasn't been brought up adequately before, and it deserves to be countered...the idea that medical innovation will go by the wayside if we switched away from our current system.

 

Now, as far as I can tell, there's no reason to believe this will be true, for a couple reasons. First, a ton of our medical research actually comes out of the socialized NIH, NSA, and other universities. Second, pharmaceutical companies don't spend that much on research anyway, and the amounts have gone through the floor over the past few years. Especially compared with the amounts they spend on advertising. And third...what companies spend their research dollars on isn't necessarily what's best for medical treatment anyway...it's what's most profitable. Therefore, we get enormous sums spent on finding different ways to get around patents/generic drug laws, and we get every pharmaceutical company developing and spending billions to advertise their own E.D. treatment every night, while things like development of new manufacturing techniques for flu shots sits laggard behind other, more profitable priorities.

 

Here's an interview with a more detailed look at the answer.

[southsider2k5]

Because our system is designed in a way such that everyone makes more money the more they do. The more procedures a doctor orders, the more money they make. You guys like capitalism, you ought to understand that concept; if you make more money by ordering more care, you're going to order more care for people.

 

The British, IIRC, do something different. If you pay doctors on salary, even if they're making really, really good salaries, then you remove the economic incentive where it benefits a doctor to overtreat.

 

This points back directly to that test-case in El Paso TX we talked about a few times, where in McAllen TX, the doctors were ordering vastly more care for the same amount of tests as the city next door and were getting worse health care outcomes.

 

So in other words you are admitting people will be getting less care, and less quality of care, while the government forces people to have less tests. Interesting.

[BigSqwert]

So in other words you are admitting people will be getting less care, and less quality of care, while the government forces people to have less tests. Interesting.

That's not how I read it.

[Balta1701]

So in other words you are admitting people will be getting less care, and less quality of care, while the government forces people to have less tests. Interesting.

And yet you're more than willing to say right now that people who can't afford tests shouldn't get them. That's what our current system does to the letter. Even for people with some insurance, but especially for people with none.

 

Not only does this perspective continue to be inhumane...but it's still more expensive than utilizing regular, preventative care. And it's another key factor in why we appear to have a "Doctor shortage" or "Capacity shortage" or however you're defining it.

[kapkomet]

And yet you're more than willing to say right now that people who can't afford tests shouldn't get them. That's what our current system does to the letter. Even for people with some insurance, but especially for people with none.

No, it's not. You want treatment, you get treatment. Oh, but you might have to pay for it.

 

[Balta1701]

No, it's not. You want treatment, you get treatment. Oh, but you might have to pay for it.

Going to the ER when your body finally gives out is not getting treatment. Going to the ER for cancer, or diabetes, or even hell the Swine Flu is not getting treatment. And I still can't figure out why you're so thrilled to foot the bill for that. It's like I offer you a $5000 tax bill or a $10000 tax bill and you decide you want to pay the latter.

[NorthSideSox72]

You guys are hilarious, with the lobbing of hyperbole and absolutes from either side of the aisle. Its like being in Congress without the suits and parliamentary procedures.

 

[lostfan]

You guys are hilarious, with the lobbing of hyperbole and absolutes from either side of the aisle. Its like being in Congress without the suits and parliamentary procedures.

lol. My eyes are starting to glaze over.

[southsider2k5]

Going to the ER when your body finally gives out is not getting treatment. Going to the ER for cancer, or diabetes, or even hell the Swine Flu is not getting treatment. And I still can't figure out why you're so thrilled to foot the bill for that. It's like I offer you a $5000 tax bill or a $10000 tax bill and you decide you want to pay the latter.

 

Yeah, the problem is when the government gets involved it will be the third option. An even bigger tax bill.

[chunk23]

When someone skips out on an ER bill, which is pretty common because an uninsured person pays 2.5 the rate an insured person would, the cost is placed on the taxpayer. By providing insurance, that cost would be lowered, because 1) they would be charged the insured rate, and 2) there is less incentive to skip out on the bill.

 

Also, every bill being considered at this point has the public option as budget neutral, so it wouldn't add to taxes. They're supposed to be self-sufficient on premiums and deductibles.