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Re: House bill would make health care a right

Postby pablonite » Wed 22 Jul 2009, 01:00:14

Fixing the biggest fundamental problem with "health care" generates too many conflicts of interest in a fascist capitalist state like America.

An ounce of prevention is worth a pound of cure. The pound is where the money is. :)

Now shut up and wash down those potato chips with a carbonated sugar drink and watch some TV.
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Re: House bill would make health care a right

Postby AgentR » Wed 22 Jul 2009, 12:07:08

$this->bbcode_second_pass_quote('Ludi', '')$this->bbcode_second_pass_quote('AgentR', 'T')he real problem with our health care system, is that no one has a financial motivation to say "no" when a doctor tries to sell you something.


It must be great to have such fabulous insurance. No deductible? Mine is something like $5000.00. So I am quite happy to refuse unnecessary tests and procedures.


You are missing the point of what I wrote. The insurance companies do have a motive to say "no"; but they are outside of the sales pitch, and get lambasted and sued when they refuse things that are truly expensive; thus driving the cost further along. In your instance, you have a motive to avoid "unnecessary" services, costing a few hundred or a couple thousand... But do you have a financial motivation to say "no" to the life saving/extending procedure that costs $200,000 ?

A government payer on the other hand can legislate itself liability immunity. It can look at the expensive patient who could be given six months of pain management and a funeral, or five million worth of medical services with a funeral three to five years later and say, "no sale, here's your morphine." Personally, I wish they'd say it more directly, but in practice, the way they say it is with delays in getting appointments for various waypoints along the treatment path, so that the patient who chooses to fight for the expensive care, chases it, but never gets it.

The reality is that the days where America could pay for the health care that we are accustomed to are rapidly approaching "the end". Biden's right, the thing is completely unsustainable as it exists now; either we fix it, or it will FIX us, and soon. [not saying I approve of the administration's plan in any way, as I believe it will make the problems much worse, but at least it puts the ball in play.]
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Re: House bill would make health care a right

Postby mattduke » Wed 22 Jul 2009, 14:39:26

Uh oh folks. Better read the fine print. Individual private health insurance will be outlawed under the bill.

http://www.ibdeditorials.com/IBDArticle ... 8165656854
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Re: House bill would make health care a right

Postby Pretorian » Wed 22 Jul 2009, 19:06:41

$this->bbcode_second_pass_quote('mattduke', 'U')h oh folks. Better read the fine print. Individual private health insurance will be outlawed under the bill.

http://www.ibdeditorials.com/IBDArticle ... 8165656854



So? Who is going to cry for them? In any insurance system healthy people are paying for sick people's issues.
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Re: House bill would make health care a right

Postby smallpoxgirl » Thu 23 Jul 2009, 02:54:06

$this->bbcode_second_pass_quote('Pretorian', 'S')o? Who is going to cry for them? In any insurance system healthy people are paying for sick people's issues.


It's not just that. People have lost track of what "insurance" is all about in America. Insurance is supposed to defer risk of some catastrophic but unlikely event. If you are using your "insurance" on a regular basis, you no longer have insurance. You now have a bill payment service. I don't get health insurance from my employer so I had to find my own. The plan that I picked costs me $80 a month. It's got a $5000 deductible and a $6500 per year out of pocket cap. That's insurance. Most years, I will pay my own health care expenses. If something unexpected and catastrophic happens, I'm covered and covered well, and it's pretty affordable. If I wanted the $200 deductible plan that covered prescriptions, two things happen. First off, the premium goes up by about 5 times. Secondly, the out of pocket cap goes way up. At that point, you're no longer purchasing insurance. You're paying a third party to pay all your medical bills. No way do you win in doing that. In America everyone expects to use their insurance when they have any medical bill, and most of them, predictably have medical bills. They think that if they can externalize their medical costs to a third party, then they don't have to think about the cost of the care that they want. It's sort of like thinking that car insurance can somehow allow everyone to drive a Mercedes. Obviously if everyone develops that mentality, then the Honda dealer is going to close and car insurance payments will start to approximate the cost of a Mercedes payment (plus a 25% gratiuty for the insurance company). Then everyone will think their Mercedes is kind of dowdy. They'll start wondering why they can't have the Porsche or the Ferrari. The other thing that happens is that healthy people start to feel like they're wasting money on this health insurance and not getting anything back. They start wanting to go to the doctor just to get their money's worth out of their insurance. Why would anyone want to take the bus if you're "entitled" to a Mercedes? We need a reality check in this country about the fact that we waste ENORMOUS amounts of money on testing and treatments that are of dubious benefit. We do it because everyone thinks they can externalize the costs to someone else and no one is really very worried about cost containment. Certainly not worried enough to do anything about it anyway. You can imagine what would happen to car dealerships if everyone who walked in the door said "I want whatever you think I need. Money is no worry. The insurance company is paying for it."
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Re: House bill would make health care a right

Postby mattduke » Thu 23 Jul 2009, 08:21:19

Overheard at a baseball game: $this->bbcode_second_pass_quote('', '&')quot;I couldn't believe it, the bill came out to $15,000!". "Wow, how did you pay for it?" "Oh, Medicare paid for it".
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Re: House bill would make health care a right

Postby vision-master » Thu 23 Jul 2009, 08:53:49

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('Pretorian', 'S')o? Who is going to cry for them? In any insurance system healthy people are paying for sick people's issues.


It's not just that. People have lost track of what "insurance" is all about in America. Insurance is supposed to defer risk of some catastrophic but unlikely event. If you are using your "insurance" on a regular basis, you no longer have insurance. You now have a bill payment service. I don't get health insurance from my employer so I had to find my own. The plan that I picked costs me $80 a month. It's got a $5000 deductible and a $6500 per year out of pocket cap. That's insurance. Most years, I will pay my own health care expenses. If something unexpected and catastrophic happens, I'm covered and covered well, and it's pretty affordable. If I wanted the $200 deductible plan that covered prescriptions, two things happen. First off, the premium goes up by about 5 times. Secondly, the out of pocket cap goes way up. At that point, you're no longer purchasing insurance. You're paying a third party to pay all your medical bills. No way do you win in doing that. In America everyone expects to use their insurance when they have any medical bill, and most of them, predictably have medical bills. They think that if they can externalize their medical costs to a third party, then they don't have to think about the cost of the care that they want. It's sort of like thinking that car insurance can somehow allow everyone to drive a Mercedes. Obviously if everyone develops that mentality, then the Honda dealer is going to close and car insurance payments will start to approximate the cost of a Mercedes payment (plus a 25% gratiuty for the insurance company). Then everyone will think their Mercedes is kind of dowdy. They'll start wondering why they can't have the Porsche or the Ferrari. The other thing that happens is that healthy people start to feel like they're wasting money on this health insurance and not getting anything back. They start wanting to go to the doctor just to get their money's worth out of their insurance. Why would anyone want to take the bus if you're "entitled" to a Mercedes? We need a reality check in this country about the fact that we waste ENORMOUS amounts of money on testing and treatments that are of dubious benefit. We do it because everyone thinks they can externalize the costs to someone else and no one is really very worried about cost containment. Certainly not worried enough to do anything about it anyway. You can imagine what would happen to car dealerships if everyone who walked in the door said "I want whatever you think I need. Money is no worry. The insurance company is paying for it."


Why don't you Doctors start standing up to the insurance companies?
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Re: House bill would make health care a right

Postby mattduke » Thu 23 Jul 2009, 09:04:14

$this->bbcode_second_pass_quote('vision-master', '')$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('Pretorian', 'S')o? Who is going to cry for them? In any insurance system healthy people are paying for sick people's issues.


It's not just that. People have lost track of what "insurance" is all about in America. Insurance is supposed to defer risk of some catastrophic but unlikely event. If you are using your "insurance" on a regular basis, you no longer have insurance. You now have a bill payment service. I don't get health insurance from my employer so I had to find my own. The plan that I picked costs me $80 a month. It's got a $5000 deductible and a $6500 per year out of pocket cap. That's insurance. Most years, I will pay my own health care expenses. If something unexpected and catastrophic happens, I'm covered and covered well, and it's pretty affordable. If I wanted the $200 deductible plan that covered prescriptions, two things happen. First off, the premium goes up by about 5 times. Secondly, the out of pocket cap goes way up. At that point, you're no longer purchasing insurance. You're paying a third party to pay all your medical bills. No way do you win in doing that. In America everyone expects to use their insurance when they have any medical bill, and most of them, predictably have medical bills. They think that if they can externalize their medical costs to a third party, then they don't have to think about the cost of the care that they want. It's sort of like thinking that car insurance can somehow allow everyone to drive a Mercedes. Obviously if everyone develops that mentality, then the Honda dealer is going to close and car insurance payments will start to approximate the cost of a Mercedes payment (plus a 25% gratiuty for the insurance company). Then everyone will think their Mercedes is kind of dowdy. They'll start wondering why they can't have the Porsche or the Ferrari. The other thing that happens is that healthy people start to feel like they're wasting money on this health insurance and not getting anything back. They start wanting to go to the doctor just to get their money's worth out of their insurance. Why would anyone want to take the bus if you're "entitled" to a Mercedes? We need a reality check in this country about the fact that we waste ENORMOUS amounts of money on testing and treatments that are of dubious benefit. We do it because everyone thinks they can externalize the costs to someone else and no one is really very worried about cost containment. Certainly not worried enough to do anything about it anyway. You can imagine what would happen to car dealerships if everyone who walked in the door said "I want whatever you think I need. Money is no worry. The insurance company is paying for it."


Why don't you Doctors start standing up to the insurance companies?

Similar to the manner in which government tax breaks for mortgage interest payments tilted the game towards bidding up house prices, government tax breaks for employer provided health insurance has tilted the game towards insurance.
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Re: House bill would make health care a right

Postby AlexdeLarge » Thu 23 Jul 2009, 10:44:37

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Re: House bill would make health care a right

Postby vision-master » Thu 23 Jul 2009, 11:15:16

What's the matter, you gonna have to provide medical insurance for your mexican workers taking the burden off the State? :lol:
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Re: House bill would make health care a right

Postby smallpoxgirl » Thu 23 Jul 2009, 11:42:20

$this->bbcode_second_pass_quote('vision-master', 'W')hy don't you Doctors start standing up to the insurance companies?


Same reason doctors move from Canada to the US not vice versa. Ultimately doctors aren't that different from anybody else. Given enough iterations of choosing between ethics and personal gain, personal gain always wins out in the end. Doctors all have mortgage payments too. Why would they complain about the high cost of health care? They're part of that cost. They justify it to themselves with a lot of inspeak about patient choice and quality improvement and that sort of thing.

Perfect example. Patient comes in. Says "I want to start taking Yaz." I have two choices here. I can spend 30 seconds writing a script for Yaz. (particularly convenient since it has such a short name.) The patient will leave smiling, and I'll have a couple of minutes to grab a cup of coffee before my next appointment. Or I can spend 5 minutes trying to explain to the patient that the slick Yaz commercial she's seen 50 times on TV in the last week was garbage, and Sprintec will do exactly the same thing for her at $4 per month instead of $60 per month. In that case, there's a decent chance the patient is going to leave disgruntled. She really doesn't care about the cost because she's not paying it anyway and that Yaz commercial was soooo cool. I end up late for my next patient who then is also disgruntled. The system is not set up to encourage frugality. It's set up to punish it.
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Re: House bill would make health care a right

Postby mattduke » Thu 23 Jul 2009, 12:09:06

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('vision-master', 'W')hy don't you Doctors start standing up to the insurance companies?


Same reason doctors move from Canada to the US not vice versa. Ultimately doctors aren't that different from anybody else. Given enough iterations of choosing between ethics and personal gain, personal gain always wins out in the end. Doctors all have mortgage payments too. Why would they complain about the high cost of health care? They're part of that cost. They justify it to themselves with a lot of inspeak about patient choice and quality improvement and that sort of thing.

Perfect example. Patient comes in. Says "I want to start taking Yaz." I have two choices here. I can spend 30 seconds writing a script for Yaz. (particularly convenient since it has such a short name.) The patient will leave smiling, and I'll have a couple of minutes to grab a cup of coffee before my next appointment. Or I can spend 5 minutes trying to explain to the patient that the slick Yaz commercial she's seen 50 times on TV in the last week was garbage, and Sprintec will do exactly the same thing for her at $4 per month instead of $60 per month. In that case, there's a decent chance the patient is going to leave disgruntled. She really doesn't care about the cost because she's not paying it anyway and that Yaz commercial was soooo cool. I end up late for my next patient who then is also disgruntled. The system is not set up to encourage frugality. It's set up to punish it.

Better yet, the patient should be free to go straight to a pharmacist and purchase the drug without requiring a prescription, as she might for aspirin or cocaine.
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Re: House bill would make health care a right

Postby Ferretlover » Thu 23 Jul 2009, 12:15:41

$this->bbcode_second_pass_quote('', 'H')ouse bill would make health care a right
...as long as the patient or its family can afford to pay.
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Re: House bill would make health care a right

Postby vision-master » Thu 23 Jul 2009, 12:45:23

$this->bbcode_second_pass_quote('smallpoxgirl', 'S')ame reason doctors move from Canada to the US not vice versa. Ultimately doctors aren't that different from anybody else. Given enough iterations of choosing between ethics and personal gain, personal gain always wins out in the end. Doctors all have mortgage payments too. Why would they complain about the high cost of health care? They're part of that cost. They justify it to themselves with a lot of inspeak about patient choice and quality improvement and that sort of thing.
Perfect example. Patient comes in. Says "I want to start taking Yaz." I have two choices here. I can spend 30 seconds writing a script for Yaz. (particularly convenient since it has such a short name.) The patient will leave smiling, and I'll have a couple of minutes to grab a cup of coffee before my next appointment. Or I can spend 5 minutes trying to explain to the patient that the slick Yaz commercial she's seen 50 times on TV in the last week was garbage, and Sprintec will do exactly the same thing for her at $4 per month instead of $60 per month. In that case, there's a decent chance the patient is going to leave disgruntled. She really doesn't care about the cost because she's not paying it anyway and that Yaz commercial was soooo cool. I end up late for my next patient who then is also disgruntled. The system is not set up to encourage frugality. It's set up to punish it.


My Doctor got pissed as I went straight to the lab for some blood work. Now with Lyme D I may need a rheumatologist. I called the number he gave me and it just went to the appointment desk. He gave me no referral and said I didn't need to bother with a folllow up with him. So, I called member services and found I can see a rheumatologist (private pratice but in the network) that my other family is using. Looks like he's out of the loop now. Why do Doctors hate ppl that take charge?
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Re: House bill would make health care a right

Postby smallpoxgirl » Thu 23 Jul 2009, 14:25:13

$this->bbcode_second_pass_quote('vision-master', 'W')hy do Doctors hate ppl that take charge?


Same reason cops and politicians do. Power issues.

And on a simpler level than that, health care is an industry. Mass production. Interchangable parts. If you start deviating from the assembly line, it makes more work for us and makes us grumpy.
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Re: House bill would make health care a right

Postby vision-master » Thu 23 Jul 2009, 14:50:26

$this->bbcode_second_pass_quote('smallpoxgirl', 'S')ame reason cops and politicians do. Power issues.
And on a simpler level than that, health care is an industry. Mass production. Interchangable parts. If you start deviating from the assembly line, it makes more work for us and makes us grumpy.

I see, that's what I kinda figured. Why take it out on poor little me. :( :lol:
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Re: House bill would make health care a right

Postby smallpoxgirl » Thu 23 Jul 2009, 15:06:53

$this->bbcode_second_pass_quote('vision-master', 'I') see, that's what I kinda figured. Why take it out on poor little me. :( :lol:


The nail that stands up gets pounded down. :razz:
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Re: House bill would make health care a right

Postby vision-master » Thu 23 Jul 2009, 15:15:02

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('vision-master', 'I') see, that's what I kinda figured. Why take it out on poor little me. :( :lol:
The nail that stands up gets pounded down. :razz:

Sorry, I didn't get a Doctors operating manual. :lol:
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Re: House bill would make health care a right

Postby AlexdeLarge » Fri 24 Jul 2009, 10:51:20

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Re: House bill would make health care a right

Postby rangerone314 » Fri 24 Jul 2009, 11:25:26

To reduce healthcare costs sufficiently is probably impossible, because the following are impossible or near impossible.

1) Reduce the influence of pharmaceutical companies

2) Eliminate the inefficiencies of having middlemen who produce no actual services (health insurance)

3) Reduce unnecessary services patients request (drive down demand)

4) Improve diets (drive down demand)

5) Increase # of doctors in this country (increase supply) - would be opposed by AMA
An ideology is by definition not a search for TRUTH-but a search for PROOF that its point of view is right

Equals barter and negotiate-people with power just take

You cant defend freedom by eliminating it-unknown

Our elected reps should wear sponsor patches on their suits so we know who they represent-like Nascar-Roy
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