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Author Topic: Republican Scott Brown wins special election in MA - Analysis of Democratic options
DarkKnight
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quote:
it is much less expensive to run, with only about 2% or so in administrative costs - a fraction of what private insurance spends.
There is a reason why the always boast about the percent of the administrative costs when compared to the total outlay of money. Typically, Medicare pays for very expensive items which makes it appear their admin costs are very low when the percentage is figured. I will look for some links later about this but that low admin cost is misleading.
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BlackBlade
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quote:
I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.

Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.

Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.

The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.

Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.

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steven
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quote:
Originally posted by DarkKnight:
quote:
it is much less expensive to run, with only about 2% or so in administrative costs - a fraction of what private insurance spends.
There is a reason why the always boast about the percent of the administrative costs when compared to the total outlay of money. Typically, Medicare pays for very expensive items which makes it appear their admin costs are very low when the percentage is figured. I will look for some links later about this but that low admin cost is misleading.
Hmm, that's weird...I think I heard that the administrative costs of healthcare are a much, much higher portion of the total amount spent in the US versus other industrialized countries.

Got any thoughts there? I bet not.

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Kwea
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Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
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kanelock1
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quote:
Originally posted by BlackBlade:
quote:
I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.

Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.

Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.

The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.

Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.

[Confused]

[ January 26, 2010, 01:47 AM: Message edited by: kanelock1 ]

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Darth_Mauve
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I hear people arguing for proof that the American health system is broken. Every proof they find they are able to chip away at with innuendo, anecdotes, and odd statistics.

The only argument that I've heard claiming our system is working well is, "Well since we all aren't dieing every time we catch a cold, it must be OK."

That's a very low bar to meet. Haiti is doing that well.

I'm interested in finding proof that our free enterprise system of health care is doing well for those who are ill, not those who make the medicines, the insurance, or the medical decisions.

Come on those of us who are pro-health care. Stop sitting on the defensive and go on the offensive.

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TomDavidson
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quote:
That's a very low bar to meet. Haiti is doing that well.
I know that's meant to be a joke, but just for reference: at the moment, no, they're not. Conditions in Haiti are still pretty dire.
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DarkKnight
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quote:
Got any thoughts there? I bet not
Such anger....
quote:
Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
Not that it will matter but here you go....
Medicare’s Hidden Administrative Costs

Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

Medicare’s (true) Administrative Costs

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Samprimary
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from the third link:

quote:
Even with Litow’s manipulation of the numbers, Medicare seems like a better deal. Let’s see why:

Economies of scale: There are large economies of scale in the insurance business; however ,large insurance companies can certainly replicate the majority of the scale economies Medicare enjoys.
Cost of Capital: Medicare incorrectly counts its cost of capital as 0. The true cost would take into account the direct cost of hiring IRS workers to collect the taxes which pay for Medicare as well as taking into account the distortionary effects of income taxation on workers labor supply decisions. For the private sector, the costs of capital is transparent: it is simply the interest rate.
Demographics: Medicare serves the elderly population and thus has a high cost per enrollee. In 2003, the average medical cost for Medicare was $6,600 per person per year, while the same figure for private insurance was $2,700. Thus, if public and private health insurance had the same administrative cost per person, Medicare would still be seen as ‘more efficient’ since Medicare’s administrative cost ratio would be less than half the size of the private insurance’s cost ratio.

interesting! even with our system hardly being the paragon of medical system efficiency, it still beats out private.
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BlackBlade
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quote:
Originally posted by kanelock1:
quote:
Originally posted by BlackBlade:
quote:
I'm pretty sure that our country was founded on personal responsibility and the government staying the hell out of our way.
If that were true, the Articles of Confederation would have sufficed just fine.

Also, I don't think the founding fathers had any sort of real consensus on what our founding principles were. I think it would have been hilarious to pass out a survey and see what their responses were.

Contrary to your opinions, the founding fathers did not view government as poison, unless you were Thomas Jefferson before he actually became president. The role of government in our lives has increased ever since The Articles of Confederation were ratified. There has never been a prolonged dis-institutionalization of the government, there has always been a recognition of what is and is not working in the private sector followed by a governmental take over.

The military works better if it's controlled centrally by the government, roads work better when regulated by the government, the postal system, civil rights, the economy, education, and now health insurance. Every single one of those concepts had a period of time where the government did not control it, and it had huge problems that people got frustrated enough to use the government to help them fix it.

Your welcome to ask for people to vote for the days of local militias, dirt roads, month long correspondence, segregation, small business, illiterate coal mining childhoods, and right now death panels for every uninsured American.

[Confused]
I'm moderately interested in knowing what your post was before you edited it. Was it, [Confused] [Confused] ?
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Mucus
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Further note, even using CAFI(an advocacy group for insurance companies)'s numbers for Medicare's costs which more than doubles the normal estimate for Medicare's costs from 2% to 5.2% and bizarrely omitting sales commissions, taxes, AND profits from the private insurance calculations, the private solution still ends up being roughly 70% more expensive in that post at 8.9% overall.

Kinda explains why the US is an out-lier in stuff like:
http://contexts.org/socimages/2010/01/10/the-relationship-between-health-spending-and-life-expectancy/
http://www.fivethirtyeight.com/2010/01/healthcare-spending-and-life-expectancy.html

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kanelock1
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It was actually Uh, What? [Confused] , as I just didn't get what you were trying to point out.
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steven
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quote:
Originally posted by DarkKnight:
quote:
Got any thoughts there? I bet not
Such anger....
quote:
Maybe because it's hard to discuss or refute something you "think you heard", without any proof or background on who you heard it from, any clue what the context was, or any discussion about their actual credentials or access to such information.
Not that it will matter but here you go....
Medicare’s Hidden Administrative Costs

Medicare Administrative Costs Are Higher, Not Lower, Than for Private Insurance

Medicare’s (true) Administrative Costs

To clarify, I heard this information on an NPR interview.

Here is a quote from the Wiki on "Health Care in the United States" (exact title)--

"The health care system in the U.S. has a vast number of players. There are hundreds, if not thousands, of insurance companies in the U.S.[64][138] This system has considerable administrative overhead, far greater than in nationalized, single-payer systems, such as Canada's. An oft-cited study by Harvard Medical School and the Canadian Institute for Health Information determined that some 31% of U.S. health care dollars, or more than $1,000 per person per year, went to health care administrative costs, nearly double the administrative overhead in Canada, on a percentage basis.[139]"

And another quote, from the same Wiki:

According to a report published by the CBO in 2008, administrative costs for private insurance represent approximately 12% of premiums. Variations in administrative costs between private plans are largely attributable to economies of scale. Coverage for large employers has the lowest administrative costs. The percentage of premium attributable to administration increases for smaller firms, and is highest for individually purchased coverage.[144] A 2009 study published by the Blue Cross and Blue Shield Association found that the average administrative expense cost for all commercial health insurance products was represented 9.18% of premiums in 2008.[145] Administrative costs were 11.12% of premiums for small group products and 16.35% in the individual market.[145]

Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?


DarkKnight, kanelock, et al, were you aware of these numbers?

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King of Men
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quote:
Originally posted by Darth_Mauve:
I hear people arguing for proof that the American health system is broken. Every proof they find they are able to chip away at with innuendo, anecdotes, and odd statistics.

The only argument that I've heard claiming our system is working well is, "Well since we all aren't dieing every time we catch a cold, it must be OK."

The post I was objecting to claimed that anyone with anything remotely serious is kicked from their insurance program and, presumably, either dies or goes bankrupt. Would you like to defend that claim? Or can we both recognise that, while the system can use some reform, we're not talking immediate-action-required, asteroid-hitting-the-Earth style disaster?
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AvidReader
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I don't even dispute that for some people, it really is end of the world disaster time. My question is, how big is the raft we can put them on? I hate to be a Vulcan about it, but sinking the raft and killing everyone doesn't help.

People in Europe spend less and die less. Ok. Is that because of their healthcare or because of a variety of factors including genetics, lower fat diets, more walking, or any number of cultural factors? Which bits of American health are broken and how do we fix them?

I just feel like the current proposals have us running off half-cocked after the answers we think we should get. I guess I love science too much to be swayed by that. What are the facts? What will really help, not what should help?

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Darth_Mauve
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Nope. Can't recognize that.

Immediate action is required.

While this is not the "Earth-hitting-the-Earth" style disaster, there are people dieing out there because they can't afford to go to the doctor.

Bankruptcy is bad.

Taxes and costs are something that we can debate and worry about down the road.

But right now people are debating whether they can afford the deductible and see that doctor about the twitch in their face, or they should wait and pray it goes away. When that twitch continues onto a stroke--that's it.

We can talk about politics.

We can talk about humiliating liberals or Democrats or President Obama.

But the issue is people, children in many cases, who are dieing because they can't afford the doctor...

or the doctor can't afford to see them...

or the medication they are on is too expensive so they go without...

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Lyrhawn
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quote:
Originally posted by AvidReader:
I don't even dispute that for some people, it really is end of the world disaster time. My question is, how big is the raft we can put them on? I hate to be a Vulcan about it, but sinking the raft and killing everyone doesn't help.

People in Europe spend less and die less. Ok. Is that because of their healthcare or because of a variety of factors including genetics, lower fat diets, more walking, or any number of cultural factors? Which bits of American health are broken and how do we fix them?

I just feel like the current proposals have us running off half-cocked after the answers we think we should get. I guess I love science too much to be swayed by that. What are the facts? What will really help, not what should help?

Honestly?

I think we know most of that. I've read way too many reports and studies of what is wrong, and what we think will be the best solution to fix it. It requires a massive and fundamental overhaul not only of how we pay for health care, but of how we provide it at the ground level.

And generally, most of those reports say the same thing.

We have to stop paying for care based on services provided and have to start paying based on the CARE provided. In other words, don't pay for 20 tests that a doctor order, pay for how healthy he made you. It's been tried in a number of smallish test cases, and in every case, it cut down on costs, cut down on waste, increased the quality of care, reduced complications, and satisfied everyone. Hospitals didn't lose money, doctors weren't paid less, customers paid less, and everyone went home healthy at the end of the day.

That should both bring costs down and make us healthier. And frankly, I think we should get the ball rolling on that before we discuss health insurance, but I guess I don't see why we can't do both at once.

The problem isn't that we don't know what to do. We've been studying the issue for what, more than 20 years? 30 years? We have information and statistics coming out of our ears. This is an ideological fight, not an empirical one. It's not evidence based. It's feelings based. Until we get over that hurdle, I'm not sure how we fix the problem at the procedural level.

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DarkKnight
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quote:
We have to stop paying for care based on services provided and have to start paying based on the CARE provided. In other words, don't pay for 20 tests that a doctor order, pay for how healthy he made you. It's been tried in a number of smallish test cases, and in every case, it cut down on costs, cut down on waste, increased the quality of care, reduced complications, and satisfied everyone. Hospitals didn't lose money, doctors weren't paid less, customers paid less, and everyone went home healthy at the end of the day.

Links?
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Geraine
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quote:
Originally posted by Darth_Mauve:
Nope. Can't recognize that.

Immediate action is required.


Taxes and costs are something that we can debate and worry about down the road.

But right now people are debating whether they can afford the deductible and see that doctor about the twitch in their face, or they should wait and pray it goes away. When that twitch continues onto a stroke--that's it.

We can talk about politics.

We can talk about humiliating liberals or Democrats or President Obama.

But the issue is people, children in many cases, who are dieing because they can't afford the doctor...

or the doctor can't afford to see them...

or the medication they are on is too expensive so they go without...

1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?

So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay? Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?

2) Do you go to the hospital for routine tests and procedures? Usually dedectibles are for hospital procedures and stays. A twitch in your face can usually be tested by a regular doctor or specialist for a co-pay.

3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.

4)Poor children are covered under CHIP, so I am a little confused what you are referring to. It is easily obtainable if you need it.

5) Doctors could afford to see a lot more patients if they didn't have to worry about getting sued for trivial things or pay a ton of money into malpractice insurance.

6) Last time I checked Wal-Mart has a ton of generics for $7 a piece without insurance. If you have something more serious and there isn't a generic, there are progams out there to help you already.

I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me.

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Kwea
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Lyr, I would also like links to those. I'd like to see how it worked, and what tehir methodoligy was to be honest. I agree wiht it, but I am not sure how we would implament it.
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scholarette
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#4- Poor children covered under chip- I knew a family who made less then $50 over the chip standards (which are different depending on what state you live in). Paying $10,000 a year for health insurance is probably still not affordable for them, even with that $50 over what the state said made health care an option. (The $10k figure comes from the minimum it would have cost at the time to insure a family of four).

#5- Texas has a lot of limits on what you can sue your drs for. Guess what- our docs still overprescribe and overtest. I know one city in Texas has the highest level of health care spending- significantly higher then that of similar populations in other states. This is a nice myth to toss out (because it seemingly makes so much sense), but as long as medicine is a business, drs are going to try to convince you to do more tests then you need (not all, but enough to be an issue.)

#6- Not all meds are available and sometimes a program for your drug does not exist. We had student insurance and my husband spent about $200 a month on drugs. The insurance helped on the first $500 of that (well, after your $100 prescription deductible). We qualified for CHIP for our daughter, so our income pretty low (first year was medicaid). After the $500 was up, we had to decide which drugs we cut and which he paid for. He needed all, but we still ended up cutting them. Because our student insurance covered some part of the drugs, we could not find any programs to help us. We were "insured". This was a few years ago, but depending on your situation, it is very easy top find yourself unable to pay for your meds.

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Lyrhawn
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DK and Kwea -

None of what I've read has been online. Actually, one of them might be, but I'll have to remember where I read it. Off the top of my head.

If you want a bare bones version of what I'm talking about, check this out. I've read the Dartmouth studies mentioned in this article as well, and I'm sure you can find them with a little googling. The article isn't the hard data you're looking for, but it's a primer on the sort of care I'm referencing, and the direction I think we need to go. TIME had a similar article that involved the Mayo Clinic and Geisinger in Pennsylvania about using a sort of standardization in medical procedures. It drastically cut down on in-hospital stay time, post-surgery complications, and overall costs by creating a sort of step-by-step guide for basic procedures, rather than the haphazard way they were performed. Doctors balked at following something so rigid, but when interviewed after it was implemented, they all agreed it was a positive change that made their jobs easier and their patients healthier.

Unfortunately, that sort of evidence based standardization is the sort of thing that leads some to trot out the Death Panel like criticism of Democrats as being robots out to deny care based on charts, graphs and tables. The problem really stems from the fact that people want the right to demand tests, even when doctors say they don't need them. We have to ask ourselves whether we should be trusting 300 million plus non-doctors when they demand treatments and tests that doctors say they don't need. And if we don't trust them to basically be their own doctors, is it really unreasonable to demand that they pay for those procedures out of pocket?

Check out that TIME article, there's some good stuff, and it'll give you some good ideas on where to look for more information. I'll try to comb through the material I have to see if any of it has an online counterpart that I can link for you guys.

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theamazeeaz
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quote:
Originally posted by Geraine:
1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?

So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay? Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?

3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.

I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me. [/QB]

In the short term, isn't this better for the economy?

By nature, much of the money that will be spent implementing this bill CANNOT be outsourced. Americans* will be need to fill the administrative jobs required to keep track of the millions of people newly insured, and Americans will be the ones getting more jobs taking on more cases of sick people. Americans will also get jobs educating the people in these professions.

The wonderful thing about the medical field is that it will never be obsolete. It's also impractical to outsource, unlike, say manufacturing and phone support.

*people living in the US, independent of citizenship.

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AvidReader
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quote:
Originally posted by Lyrhawn:
We have to stop paying for care based on services provided and have to start paying based on the CARE provided.

I fully support this. I'm just not sure we need the government passing a ginormous bill full of other stuff to get it.

And even at that, I'm not sure it will completely negate the effects of our higher saturated fat diet and dependance on cars. There are probably a lot of things we should be doing to improve our health. I see healthcare as just one piece in the puzzle.

quote:
The problem really stems from the fact that people want the right to demand tests, even when doctors say they don't need them. We have to ask ourselves whether we should be trusting 300 million plus non-doctors when they demand treatments and tests that doctors say they don't need. And if we don't trust them to basically be their own doctors, is it really unreasonable to demand that they pay for those procedures out of pocket?
I love this idea. If you really think the doctor's wrong, you can still over ride him. And if you're a crazy hypochondriac who wants a magic pill instead of taking care of yourself, you're your own problem.
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BlackBlade
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I don't love that idea. Some tests in of themselves are dangerous, a doctor shouldn't have to perform a procedure they are morally against performing.
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Samprimary
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Unlimited testing at the convenience of patients without any sort of oversight by medical specialists is both economically infeasible as well as procedurally irresponsible.
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Lyrhawn
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Severe limitations would make it impossible to be much of a hindrance. Doctors perform a battery of unnecessary tests as a matter of course. It's a shotgun versus rifle approach. The basic tests might turn up something, so they do them all and hope it hits, rather than taking a more focused approach and only ordering the tests they actually think, based on the evidence, that might help the patient.

If a new evidence based policy was enacted, a lot of this testing would go away. I'm not suggesting that people should be allowed to schedule their own X-Rays or invasive procedures without the guidance of a doctor, I'm merely talking about a payment structure.

If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine. Why? Private hospitals do and always will exist that will allow people who have the money to get whatever they want done. Outlawing them isn't going to increase the care of the nation as a whole. Very few people would be able to afford these sort of tests anyway. Who has $10,000 for an X-Ray that a doctor says you don't need? Only the wealthy. And if they want to waste their money, I don't see the harm in letting them do so, especially if it keeps the idea politically viable by not appearing to restrict access based on voodoo science, which is what opponents will paint it as.

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BlackBlade
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quote:
If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine.
I could get behind that.
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steven
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Is my second post invisible?
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AvidReader
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quote:
Originally posted by BlackBlade:
quote:
If I go to the doctor and insist on a certain test and he says there's nothing to justify the test based on the evidence, but, that doing the test wouldn't hurt me, and that if I really want it, he'll okay it, but won't authorize funding for it, then I think that's fine.
I could get behind that.
Yes, I should have specified within reason.
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DarkKnight
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I'm not against the care based outcome but I have had and my wife currently has issues that we come in for, they run a battery of tests which find nothing, and we have to come back for more tests. We never insisted on any tests to be done. I'm not sure it is always patients who insist on overtesting. I've read that doctors do it to be thorough...and probably pad thier pockets some.
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Lyrhawn
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Read the article I linked to above DarkKnight.

The extra testing comes from different sources depending on who you ask. Doctors clamoring for tort reform claim it's defensive medicine to make sure no one sues them.

The people who actually make the machines, and by the way who wield a decent chunk of power in the lobbying effort, say that this testing is necessary to make sure nothing is missed and it's better to overtest than undertest.

Still there remains the fact that in a pay per service health care system, there's an extreme amount of money to be made in simply running up the bill as high as you possibly can for the health insurance company. But that pay doesn't always or even generally go to doctors, it goes to the hospital, which is itself overburdened by paying for the uninsured and for a large gap in medicare and medicaid repayments from the government. The Mayo Clinic, and other hospitals experimenting with new forms of care, are radically changing the way the hospitals do business, and it's drastically cutting costs while improving care, but while it cuts costs for the process as a whole, it cuts it's own income too much to be sustainable. Someone has to make up the difference somewhere (and it's mostly because medicare and medicaid short them in repayments).

DarkKnight, the problems you're describing are the direct result of a pay per service system, well, maybe with a little bit of a lawsuit happy culture that likes to sue for everything and doctors who are sort of caught up in the whole thing. Care based outcomes would fix some of that.

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Darth_Mauve
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quote:
1) So pass something now, even though we have no way of paying for it, and just worry about costs and taxes down the road?
Actually most of the bills do have ways of paying for it, but those ways are debated and who ever ends up having to pay for any part of it screams louder than the hospital patient. Your argument that there is "No way" of paying for it is hyperbole and wrong.

quote:
So I guess we should just spend more money we do not have, which will then lead to higher taxes on individuals and businesses, and result in less jobs and pay?
An out of control health care system costs individuals and businesses much more than higher taxes, and results in less jobs and pay. Taxes are not the only expenses individuals and companies have to pay.

quote:
Isn't spending one of the reasons people hated Bush so much, and one of the reasons our current administration has been losing support?
Spending is one of the reasons Conservatives hated President Bush. Most economists agree that spending is required to get out of a recession.

quote:
2) Do you go to the hospital for routine tests and procedures? Usually dedectibles are for hospital procedures and stays. A twitch in your face can usually be tested by a regular doctor or specialist for a co-pay.
Last time I went in for migraine headaches. I was sent to get an MRI to make sure it wasn't a tumor. This was done at an "imaging center" down the street. Cost--the bill sent to my insurance was over $4,500. They argued 20% had to come out of my deductible.

Stress test was ordered in conjunction with a CT skan. Same result with a different fee.

quote:
3) Health care reform isn't about politics or trying to humiliate democrats or Obama. It is about two different ideals. One that promotes reliance on the government or one that promotes personal responsibility.
Oh I agree that I, not my government, not my doctor, or my insurance company is responsible for my health. But I am not responsible for most of the illnesses that hit me. They are random acts of chance--whether I get a stroke or a rare disease or hit by a bus. Some diseases we can label with fault--smoking, drinking, sins of health of one kind or the other. Still most are random. Insurance is supposed to help me financially survive random disasters. At present that system is broken--becoming a planned financial disaster that I pay for every month.

quote:
4)Poor children are covered under CHIP, so I am a little confused what you are referring to. It is easily obtainable if you need it.
Really? Ever try to get it? It was being cut under President Bush, and only back up to pre-Bush standards under President Obama.

quote:
5) Doctors could afford to see a lot more patients if they didn't have to worry about getting sued for trivial things or pay a ton of money into malpractice insurance.
That is totally uninformed.

The reason they must rush through patients is the very limited fees insurance companies pay for patient care combined with the large amounts of paperwork they are required to maintain.

For a political party that pushes personal responsibility over everything else, and the power of the market to fix things, there is this big call to limit lawsuits on doctors. Why? If a doctor screws up, and has a pattern of screwing up, shouldn't they have to pay for it?

quote:
6) Last time I checked Wal-Mart has a ton of generics for $7 a piece without insurance. If you have something more serious and there isn't a generic, there are progams out there to help you already.
Yes, $7 generics for the most common medicines. Too bad that people have to take the less common ones on a very common basis. My mother spends over $400-$600 a month on medication for her and my father. Some of that, thankfully, is covered by the VA. But once they hit their insurance limit the $200/month medications mean they have No Discretionary Fund, and start going in debt with the phone company and other utilities.

quote:
I want health care reform, but I want the right kind of health care reform. We are talking about 1/6th of our entire economy here. Doing it now and worrying about the cost later doesn't cut it for me.
Doing it later is fine, as long as you can guarantee me that the later will get here. We've been working on Health Care Reform for 60+ years, since Truman. How much longer do you want to take? You say later, but all I hear is "Tomorrow" and we all know that "Tomorrow" never comes.
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steven
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quote:
Originally posted by DarkKnight:
I'm not against the care based outcome but I have had and my wife currently has issues that we come in for, they run a battery of tests which find nothing, and we have to come back for more tests. We never insisted on any tests to be done. I'm not sure it is always patients who insist on overtesting. I've read that doctors do it to be thorough...and probably pad thier pockets some.

I'd just be happy if you'd answer the post where I quoted the wiki article. I'd take anything, even something without substance, if you'd just respond.

I really don't think I'm being treated fairly...

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malanthrop
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I hear a lot about how bad the American health care system is. The Florida hospitals are full of Haitians right now. Where's Cuba? According to Michael Moore, Cuba is better than the US.
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Lyrhawn
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What's your point?

You just said three things that are perhaps tangentially related, but failed to apply any sort of analysis that might make those three things worthwhile to mention in concert.

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DarkKnight
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quote:
Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?
Destroying hundreds, if not thousands, of businesses and unemploying thousands and thousands of people to save some administrative costs is not a very good arguement to me.
You are making a valid arguement for gigantic corporations though, like WalMart and so on.
For healthcare doing things like allowing businesses to compete across state lines will increase competition and lower costs.

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steven
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quote:
Originally posted by DarkKnight:
quote:
Here's my question--if economy of scale is the issue, (as the second bolded quote seems to point to), why wouldn't the biggest economy of scale, a government-run option, have the lowest administrative cost?
Destroying hundreds, if not thousands, of businesses and unemploying thousands and thousands of people to save some administrative costs is not a very good arguement to me.

Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
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DarkKnight
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quote:
Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
Using similar logic, we don't need fix healthcare at all. People can afford it...and if they can't, that's how it goes.
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DarkKnight
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quote:
DarkKnight, the problems you're describing are the direct result of a pay per service system, well, maybe with a little bit of a lawsuit happy culture that likes to sue for everything and doctors who are sort of caught up in the whole thing. Care based outcomes would fix some of that.
I'm not against care based outcomes, I just want to make sure that we have something in place so that we don't run into the opposite problem of symptom X equals test Y and that is it. Medicine is not always an exact science.
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steven
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quote:
Originally posted by DarkKnight:
quote:
Those people can find other jobs...and if they can't, that's how it goes. I've been laid off before. It's a learning experience.
Using similar logic, we don't need fix healthcare at all. People can afford it...and if they can't, that's how it goes.
I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
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Kwea
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Blackblade and Lyr...thanks for the links, both of you. I'll check them out later when I have some time to do so. [Big Grin]

BB....I work in health care, and have seen a lot of things first hand, but it's not like I don't worry about costs or starting a public option myself.

I wouldn't promise to change my mind overnight, but I am always interested in hearing someone else's views on things, as long as they listen to my points as well. They don't have to agree, just listen.

Thank you for doing so. [Big Grin]

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DarkKnight
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quote:
I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
Your earlier comments are still coming back to haunt you... Find another job that has health benefits, it can be a learning experience.
EDIT: I'm actually trying to help you with this question...
How much would insurance cost you?

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steven
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quote:
Originally posted by DarkKnight:
quote:
I'm tired of paying ridiculous amounts for my healthcare. I can't afford insurance, even though I work more than 40 hours a week.
Your earlier comments are still coming back to haunt you... Find another job that has health benefits, it can be a learning experience.
EDIT: I'm actually trying to help you with this question...
How much would insurance cost you?

My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
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DarkKnight
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quote:
My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
Just to clarify, your company has a health insurance plan but your monthly contribution is $180? Does your company provide any money towards health care and your share is $180? Or is it the company plan costs $180 per month, take it or leave it?
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steven
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quote:
Originally posted by DarkKnight:
quote:
My job HAS health benefits. I can't AFFORD my portion. Or, to put it another way, I'd rather eat and put gas in my car than pay my $180-a-month portion. Food and gas come first. Shocker, huh?
Just to clarify, your company has a health insurance plan but your monthly contribution is $180? Does your company provide any money towards health care and your share is $180? Or is it the company plan costs $180 per month, take it or leave it?
$180 a month is my portion. They would pay the other half, if I were to choose it.
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DarkKnight
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quote:
$180 a month is my portion. They would pay the other half, if I were to choose it.
Have you looked at getting health insurance outside of your company? I did a google search and this is the first link that came up so I'm not endorsing it, just providing it to see if it might help you find cheaper insurance.
eheatlhinsurance

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steven
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quote:
Originally posted by DarkKnight:
quote:
$180 a month is my portion. They would pay the other half, if I were to choose it.
Have you looked at getting health insurance outside of your company? I did a google search and this is the first link that came up so I'm not endorsing it, just providing it to see if it might help you find cheaper insurance.
eheatlhinsurance

Actually, my parents pay for a policy for me, an excellent one, for about $200 a month. I'm a healthy white male, mid-30s, non-smoker, drink very little, no drugs, eat healthy, height/weight proportionate...and my parents STILL have to pay $200 a month for me.

The company policy is more expensive because it has to average in the cost of 400-pound black women who smoke 2 packs a day and eat junk food.

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DarkKnight
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quote:
Actually, my parents pay for a policy for me, an excellent one, for about $200 a month. I'm a healthy white male, mid-30s, non-smoker, drink very little, no drugs, eat healthy, height/weight proportionate...and my parents STILL have to pay $200 a month for me.

So you do have excellent health care so I am not sure what your why you have a complaint? You could find a cheaper plan if you looked around though.
quote:
The company policy is more expensive because it has to average in the cost of 400-pound black women who smoke 2 packs a day and eat junk food.
And we are done... Wow. Was that necessary? Really?
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fugu13
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DK: of course, all the cheaper plans would have much higher deductibles.
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