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Health Care solution - Beggers can't be choosers
A possible solution to the Health Care problem
Print Health Care solution - Beggers can't be choosers | |
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BitterCrank
Tenured Poster  Usergroup: Members Joined: Mar 01, 2008 Location: Minneapolis Total Topics: 32 Total Posts: 1435 |
 #11
dclemments: You are aware, I suppose, that in critical measures of effective medical care, the USA ranks rather poorly. For instance, our infant mortality performance puts us at about 38 slots from the top. The end-of-life cost needs to be parsed out. There are the end-of-life costs for the 90 year old, and there are the end-of-life costs for the 50 year old. I suspect that some measures that doctors carry out on aged people are ineffective at improving quality of life or quantity of life, but they are very expensive. But even if they are effective, they are often going to count as end-of-life expenses. For younger patients, say those below 65 to pick an arbitrary figure, end-of-life costs are going to be high if the patient has a complex disease and doesn't make it. No matter how expensive it is, if the patient lives another 5 years the cost won't be counted as "end-of-life". When a patient presents with a complex disease, doctors can not tell whether treatment will be successful or not. You wouldn't want care withheld because the therapy might not work, would you? My partner (aged 64) is in hospice now with what started out as squamous cell skin cancer -- usually not a killer. This one metastasized, and even though the initial surgery was successful, further, undetected, metastases grew through both radiation and chemo therapies. Back surgery was needed to relieve pain (the cancer was destroying the vertebrae), but by that time we were told to seek hospice care. This was very expensive care - maybe $300,000 altogether, but it was also standard, usually successful care. That the patient dies instead of recovers, in this case, does not indicate medical waste. Work, strive, and persevere! You are all victims of a monstrous hoax. --New Yorker cartoon-- |
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BitterCrank
Tenured Poster Usergroup: Members Joined: Mar 01, 2008 Location: Minneapolis Total Topics: 32 Total Posts: 1435 |
#12
Subject: [quote=dclements] [/quote] dclements wrote: In the end, a large part of the problem is that we have only x dollars available right now to take care of people that can't afford it and we can either tax people more so that we can cover more people or we can find a way that the money we have goes farther to cover more people. There is one thing the congress could do that would cut costs fairly dramatically: It could repeal the law it passed several years ago that prohibits the government from negotiating drug prices for Medicare. OF COURSE drugs are expensive when you pay whatever Pfizer, Merck, or Johnson & Johnson et al decide to charge. The other thing that would lower costs is a single payer system. Single payer saves money in at least two ways: #1 is that it cuts the cost of paper processing drastically. Shuffling paper has no positive health outcomes. #2 is that single payer has enormous leverage in negotiating payments. This might cut into the incomes of $1,000,000 doctors. dclements wrote: So far I have not meet anyone that is opposed to more taxes is against the idea that clinics be set up to help take care of people that can't afford it as long as people running the clinics do it in a way that is very cost effective. Although health care would be available to more people it likely mean that not all of the most expensive treatments would not be as readily available. Oh, hey, that system already has been set up: its called the emergency room, and more often than not the care is provided at tax-supported county or municipal hospitals. By the way, if someone comes in with an (internal) abdominal abscess complicated by diabetes, and lung disease, which treatments are you going to cross off the list of possibilities? Here's an ethics question for you: Why does a person with health insurance deserve better care than a person who does not have health insurance? Where does the quality of deserving state-of-the art-brain surgery come from? The wallet? Employment status? What? Work, strive, and persevere! You are all victims of a monstrous hoax. --New Yorker cartoon-- |
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BitterCrank
Tenured Poster Usergroup: Members Joined: Mar 01, 2008 Location: Minneapolis Total Topics: 32 Total Posts: 1435 |
#13
dclements wrote: ...outrageous medical expenses draining an already anemic economy... What part of medical expenses do you find outrageous -- the money spent on you, or the money spent on undeserving beggars? Or is the $1,000,000+ a year doctors' salaries that you find outrageous? For me its the unreasonable but all-too-customary over the top salaries. But that's just me. Does money spent on medical care, let's say that none of it involves outrage, drain the economy? Almost all of the money spent on medical care is part of the domestic cycle of money: 100,000,000 people spend $1,000,000,000,000,000, 25,000,000 people receive it. They, in turn, save, invest, spend--almost all of it in this country. Presumably they don't burn it in the fire place. (That kind of expenditure goes on in the military budget: Trillions up in smoke, literally!) We spend trillions of dollars on all kinds of things every year - dog food, DVDs, McDonalds, diet cola, diving boards, drilling for oil, diapers, etc. Are those expenditures draining an already weakened economy? Medical care is to a large extent just one more service consumed. Now, I think we could do far better in terms of cost control, and I think we could do far better in terms of public benefit on the dollar. I agree with you there. But beggars aren't the problem. Edited by BitterCrank on Dec 23, 2009 - 9:50 PM Work, strive, and persevere! You are all victims of a monstrous hoax. --New Yorker cartoon-- |
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zippy
Student Usergroup: Members Joined: Dec 08, 2009 Total Topics: 0 Total Posts: 56 |
#14
BitterCrank wrote: What part of medical expenses do you find outrageous -- the money spent on you, or the money spent on undeserving beggars? Or is the $1,000,000+ a year doctors' salaries that you find outrageous? I had knee surgery a couple of years ago, and I woke up in a post op knee brace that was a fairly common device used for many knee operations. When I started getting bills after the surgery (I do have insurance) I got an odd bill from the manufacturer of the knee brace. About $750. I looked up their phone number and called them to see if they had submitted it to my ins. company, and they said they had but that I was ultimately responsible for it. So I didn't do anything - figured I would wait and see what the insurance paid. Few months later, I kept getting the same bill, so I called them back again, and again they didn't know anything about the insurance.... wanted me to pay the bill, etc.... While I was talking to them, I looked up the brace on their website. Turns out you can buy the exact same brace online for $137.99. I asked the guy if I could just buy a new one, and return it to them and call it even, and he said no, but he could knock 40% off my $750 bill. I said I bet you can. I didn't pay the bill, and I called my insurance company and told them not to pay it either, and I never got another bill in the mail. I found that a little outrageous. |
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Caldwell
Humanite  Usergroup: Moderators Joined: Apr 18, 2006 Location: Zuleiha's Crawl space Total Topics: 1 Total Posts: 2386 |
#15
All kinds of "facts" are being thrown around here just to make a case for this health care. Suddenly, a "single-payer" has less paperwork and less bureaucratic , etc. In fact, private insurers have their own system of investigation of fraud and abuses which they fund themselves. They have a system of controlling costs. And they have a system of distributing services. All of a sudden, people become "healthier" because of insurance coverage. Even the mortality rate is being brought up here. Did you know that the US have pre-natal care clinics that are accessible to everyone with or without health insurance? Edited by Caldwell on Dec 24, 2009 - 2:00 AM You said you know, but, no, you don't know. -- Xavier Boyer |
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Caldwell
Humanite Usergroup: Moderators Joined: Apr 18, 2006 Location: Zuleiha's Crawl space Total Topics: 1 Total Posts: 2386 |
#16
If you want to reform the insurance industry, then reform the insurance industry. But don't call it health care reform if you're not going to reform the health care. You said you know, but, no, you don't know. -- Xavier Boyer |
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Kwalish Kid
Tenured Poster Usergroup: Members Joined: Sep 26, 2004 Total Topics: 38 Total Posts: 4289 |
#17
dclements wrote: Read my post to Randallmay. Like all your replies on pretty much every topic, it missed the point. If anything, people in other industrialized countries are more demanding than US citizens, and these people in other countries actually get more! I imagine if Americans didn't pay for drug research either through taxes or higher prices in drugs that we could count on the magical gnomes to step in and take care of the costs. There is the possiblity that other countries would be willing to help cover the cost, but I think that the magical gnomes would be more reliable. If you don't understand the economics, don't comment on it. Just like pharmaceutical companies "used standard techniques available in a free market" to lobby Bush and other people to push forth laws that increased the cost of health care. In fact all your whining of higher prices in the US is because of people that provide health care services are "using standard techniques available in a free market" to make it expenisve for us. Again, you don't understand the economics. The US government increases drug costs for itself and for its citizens by creating monopolies for drug companies. If it funded all research directly, it would be much cheaper for it and its citizens. This is only one option, but almost any other framework (and there are many out there) is cheaper. All I said that it is possible that end of life care raises the costs of health care for everyone. So you don't have any idea about how much this is true or even a factor. I have no stats on it but from what I have heard about the amount of fraud going on it is hard to imagine it being very efficient. So, like on every topic, you shoot your mouth off without knowing anything. Look it up. Probably done with philosophy. Will check PMs from time to time. |
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Simple Occam
Professor Usergroup: Members Joined: May 14, 2007 Total Topics: 10 Total Posts: 764 |
#18
BitterCrank wrote: Why does a person with health insurance deserve better care than a person who does not have health insurance? Where does the quality of deserving state-of-the art-brain surgery come from? The wallet? Employment status? What? Access to the benefits of modern medicine is one of the gifts people get simply by living in a technologically advanced society. Just to be able to get a flu shot involves centuries of scientific research and development and countless billions in private and public investment to improve the quality of and length of our lives. The point being, that modern healthcare is EXPENSIVE and incredibly valuable to each and every one of us. No one can afford it on their own. The only way it can be widely availalbe top regular people is through some mechanism that distributes the cost of providing care over a large group of sicker and healthier people. In the US and elsewhere, this has always been... and still is... a function of private insurance companies. Insurance is the application of actuarial science to predict the large-scale likelihood of selected events (illness, injury, costs, etc.). Insurance businesses use these actuarial algorithms to determine how much in premiums, co-pays, etc. that subscribers have to pay on average for the company to make a profit. Even in a nationalize model, the same actuarial science applies. This empirical, statistical science is an essential tool of risk management. As individuals we have risks to manage, too. We, too, have to predict the likelihood of certain events occurring in our lives and take steps to prepare in advance for whatever we can. There's no way any but the most wealthy of us can afford to pay for the healthcare we will receive over our lives, so some way of sharing the risk and cost amongst a larger group is a practical necessity of life in the developed world. But the question of how we should share that risk has more than one possible answer. Whether it's done by the government as a universal entitlement for anyone who happens to be in that country or as a private ensurer of some other statistically significant group, there will be costs of administration, advertising, research, etc, in doing the risk management work. But there is a resulting benefit that derives from health risk managenent, if it is done universally that does not apply if it is not: when everyone has affordable, guaranteed access to preventive medical services, people don't get sick as much and the costs of treating all the things they didn't suffer go away. Also, the improved quality of their lives increases their availability to participate in productive behaviors that perform the work of the society. So, to answer your question, BC, a person who has health insurance pays, in some way, for his own benefits. Even with a generously subsidized company plan, I pay out over $400/month in premiums... not counting the endless co-pays and annual deductibles, or the countless hours dealing with rejected claims, authorization forms, requests for reimbursements...blablahblah.... Other than housing, it's my biggest expense. The company pays for more than half of the premuim... or they did until they eliminate my position this month. Carrying the healthcare expenses of their staff is becoming a burden companies are increasingly unable to bear. Every dime the company pays into benefits is a dime they don't have top pay in salaries and other compensation, so I really pay for that part of the benefit, too, before anyone even starts counting. So, YES, I am entitled to health insurance becasue I pay for it in a way that someone without it does NOT. When that person needs a brain surgeon, who pays for it? People who have health insurance, that's who. Which is why everyone should pay into the system in order to benefit from it. Whether it's in taxes or reduced wages or whatever...everyone should pay in. Morally and by law, those who don't have still receive benefits...sometimes the most costly services to provide. Even if they were given access to preventive services for free, it would save money and improve life quality in the long run. The problem is so broad and touches on so many critical aspects of life that to allow it to be managed entirely by market forces creates an unjust society of ther kind we have in the US today. It's unjust because the society (in this case the insurance industry and the government structures that regulate and protect it) does not return all the value it can to the individuals who contribute to and benefit from it. Too much value goes into needless and duplicative administration, immorally huge executive compensation packages, propagandistic (not informative) advertising, denials of claims, ad nauseum.... More later.... |
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Dave C
Student Usergroup: Members Joined: Nov 26, 2009 Total Topics: 0 Total Posts: 57 |
#19
The healthcare debate revolves around dollars. Let's change the equation for a minute. Take away dollars and focus instead on healthcare resources. Healthcare resources are, at any instant in time, a fixed quantity. Add more people to the system - people who had no access to the system - and you do not change the average available healthcare! You change minimum and the maximum healthcare. Now back to dollars. With universal healthcare you have those with money - the ones with healthcare - paying for others to have healthcare. At the same time that the folks with money receive reduced healthcare the folks without money receive increased healthcare. The folks with money do not like this. The folks without money like it. |
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davidasearles
Graduate Usergroup: Members Joined: Oct 15, 2009 Total Topics: 3 Total Posts: 225 |
#20
Fixed quantity? Who said that it's operating at its fixed capacity if in fact there is one? And why would the capacity remain constant. You just can't start throwing math sounding terms around and expect to be able to derive any rationality from it. |
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