Health care - administrative incompetence

[jimbob]

Having Lasik doesn't guarantee you will not need glasses. My mother has had it done (it cost a lot more than £395/eye, BTW) and she needs glasses for reading and other close work. It also isn't suitable for everyone.

Being a surgical procedure Laslk also carries risk of complications, including infection and permanent damage to vision.

And anyway, normal aging will mean that the patient will need glasses eventually anyway.

 

[Architect]

What?

A liver transplant saves a person's life.

Lasik makes it so... they don't have to wear glasses?

How on earth are you making this comparison?

Yes, that's exactly what I thought when I read her post. Apples and oranges.

 

[Architect]

Gentlemen, I'm calling "bluff" on this one. XJX has not actually addressed any substantive medical or financial point put to her. I no more believe that she is a clinic manager than I am the Queen of Sheba.

 

[Uncayimmy]

Poppycock.

You seriously believe that if every person socked away $50K for health care it wouldn't cripple the economy? Wow. Do you think it would help?

But that one entity has no incentive to lower costs. Look at everything the government runs and you will see nothing but bloat and waste.

And yet other countries don't suffer from this issue. Is the USA special?

BTW, I've done government contracts and worked for a government contractor. I see a lot more than just bloat and waste. I see the government getting great deals because the contracts are so big. There's waste and bloat everywhere. That's just life.

Why not? Why will this never happen but one-payer can?

Because in the USA right now, over 50% of people don't have any retirement savings. The median household income is $50K. There's simply a huge block of people who cannot afford to pay it. Therefore, it will never happen. Besides, you'd have to by law forbid insurance companies. Good luck with that. You can, however, tax everybody and give everyone access to national health care and let them buy private insurance if they want.

Your cash system will never happen. Never.

No, some kind of safety net insurance plan.

We don't have to pay for them.

Do you understand that your mortgage interest rate includes an amount sufficient to cover those who don't pay their mortgage? The price you pay at Wal Mart covers the costs of theft. We're paying for it - it's just not itemized.

I don't agree with this. We're at least equal in most areas, better in others, worse in some.

You only disagree because you haven't looked at the data. It's much more convenient.

There's no guarantee the government can do a better job. How do you like your school system, UY? We lag far behind other countries in Math and Science.

Non-sequitur.

There's no guarantee costs will stay the same and every indication they will go up under a one-payer system. The nation will go bankrupt to say nothing of individuals. It's silly to think costs will go down or stay the same.

Every indication that they will go up even though it's less expensive in other western democracies. That's precious! Go do some research. If you're going to argue this stuff, come armed with knowledge. Discussions on the JREF are not like arguments in a bar. People here know their **** and will demand evidence.

 

[xjx388]

I hope you don't pay for insurance, then, because most of the money you pay to an insurance company goes to paying for someone's else's healthcare (plus company profits and CEO millionaire salaries.)

I don't. I save large amounts of money per month and have a catastrophic health insurance plan, not a traditional plan. I think it's the best of both worlds. I still pool my money with others, but at very little cost to me. Yet, I'm covered if something goes horribly wrong.

I also have a very different philosophy than most posters here. I don't want to overly burden anyone with my health care. If I get cancer and I can't pay for it myself, I'm OK with the fact that I will die. I'm going to die anyway, right? As for my kids and wife, that's a little harder to admit to, but the concept remains. I'm loathe to stick my hand in your pocket to take care of my problems. If you volunteer your help out of the kindness of your heart, that's one thing and I'm appreciative. I'll pay you back any way I can. But I don't think the government should threaten you with incarceration to pay my medical bills.

 

[Uncayimmy]

Gentlemen, I'm calling "bluff" on this one. XJX has not actually addressed any substantive medical or financial point put to her. I no more believe that she is a clinic manager than I am the Queen of Sheba.

http://www.internationalskeptics.com/forums/showthread.php?t=194539 (XJX was formerly known as RJordan).

 

[kellyb]

And you don't understand the advantages of the free market. You've been marinated in a single-payer system for so long that you can't see past it.

Do you understand the difference between "industrial free market capitalism" and "finance capitalism"?

Hint: innovation and efficiency comes from the former, and that latter is just a parasitic force on the economy.

http://en.wikipedia.org/wiki/FIRE_economy

 

[Agatha]

Yuppers. I want to spend my money on myself. I want you to spend your money on yourself. That way we all have incentives to control our costs. I don't want someone else spending my money on someone else. What am I getting for 38% of my hard earned income they already take out of my pocket? Try to suppress your emotional reaction.

I don't know what healthcare you get for your 38%, but I'd be willing to bet it's less than I get for the 7.25%* I pay in tax and NI on my pitifully small salary.

Do you have medical insurance? Because if you do, you are certainly paying for other people. To make an effective comparison, you need to add the money you pay for insurance on to your tax burden.

*part time salary - £8,640
Pension contributions per year £630.72 (I've not counted this as part of my tax burden)
Tax £306.86
NI £321.75
(I'm not living on £8640; because I'm disabled, on a low income and a single parent I get some benefits from the government which are non-taxable.)

ETA http://www.thesalarycalculator.co.uk/salary.php play with salaries and see what the real burden of tax and NI is here.

 

[kellyb]

I don't. I save large amounts of money per month and have a catastrophic health insurance plan, not a traditional plan. I think it's the best of both worlds. I still pool my money with others, but at very little cost to me. Yet, I'm covered if something goes horribly wrong.

I also have a very different philosophy than most posters here. I don't want to overly burden anyone with my health care. If I get cancer and I can't pay for it myself, I'm OK with the fact that I will die. I'm going to die anyway, right? As for my kids and wife, that's a little harder to admit to, but the concept remains. I'm loathe to stick my hand in your pocket to take care of my problems. If you volunteer your help out of the kindness of your heart, that's one thing and I'm appreciative. I'll pay you back any way I can. But I don't think the government should threaten you with incarceration to pay my medical bills.

You are still paying your catastrophic policy money to pay for other people's care now.

 

[Tatyana]

I don't know what healthcare you get for your 38%, but I'd be willing to bet it's less than I get for the 7.25%* I pay in tax and NI on my pitifully small salary.

Do you have medical insurance? Because if you do, you are certainly paying for other people. To make an effective comparison, you need to add the money you pay for insurance on to your tax burden.

*part time salary - £8,640
Pension contributions per year £630.72 (I've not counted this as part of my tax burden)
Tax £306.86
NI £321.75
(I'm not living on £8640; because I'm disabled, on a low income and a single parent I get some benefits from the government which are non-taxable.)

I work for the NHS and I am taxed at about 30%, some of my wages roll over into the higher tax bracket, which I think is 35%.

I don't mind at all, I wouldn't change to the system that is in operation in the US.

I dislike having to shop for buildings, content and travel insurance, having to shop for health insurance would drive me potty.

 

[xjx388]

You seriously believe that if every person socked away $50K for health care it wouldn't cripple the economy? Wow. Do you think it would help?

Yup. It would make people more financially secure.

You can, however, tax everybody and give everyone access to national health care and let them buy private insurance if they want.

Take more money than they already are? No thanks.

Do you understand that your mortgage interest rate includes an amount sufficient to cover those who don't pay their mortgage? The price you pay at Wal Mart covers the costs of theft. We're paying for it - it's just not itemized.

Yes, this worked so well to cover all the foreclosures that caused the meltdown. Excellent.

You only disagree because you haven't looked at the data. It's much more convenient.

What data? None has been presented. Just opinions.

Non-sequitur.

You say govt. will do better in healthcare. Education is a parallel where they have NOT done better.

Every indication that they will go up even though it's less expensive in other western democracies. That's precious! Go do some research.

It's your position that it will go down. You do the research to prove me wrong. Prove that costs will go down in the US if single-payer is implemented. You can't because it's just your contention.

If you're going to argue this stuff, come armed with knowledge. Discussions on the JREF are not like arguments in a bar. People here know their **** and will demand evidence.

I have not found that to be true. Everyone is just arguing their ideology. Very few facts are in play here, even admittedly, on my side. I'm open to change, but I have yet to see persuasive data.

 

[Ivor the Engineer]

Information asymmetry is not necessarily a barrier to free market health care. You assume that doctors will gouge because they know more than you do. That's left-wing propaganda: "Doctor's are greedy!"
Milton Friedman didn't think it was a problem and he was an economist. He expressed my position much better:

Information asymmetry is one of the problems. But that isn't the primary problem which prevents a free market in healthcare.

Firstly, healthcare is not a free market like, say, the market in recorded music. People don't wake up one morning unable to function because they haven't got the latest album by their favourite artist. They are free to or not to enter the recorded music market at no cost. Contrast this to the market in healthcare where very often people have to choose between suffering and/or dying, or entering the healthcare market. There are differences on the supply side as well. I can set up a shop selling recorded music tomorrow if I want, but the supply of medical professionals is severely limited by the need to train and qualify from a medical school and obtain a medical license. I am prevented by the law from offering medical treatment to the public. These two factors ensure there will NEVER be a realistic chance of free market in healthcare emerging, no matter how much you want there to be one.

Secondly, people respond to incentives. Pay medical professionals per unit of care and they will strive to produce lots of units of care until producing an extra unit costs more than doing something else (e.g., playing golf or sailing one's yacht). Similarly, sick people will put off seeking medical care until their condition deteriorates to the point that the costs of not being treated are equal to the costs of being treated. It's a well established fact that virtually all medical conditions are less expensive to treat the earlier they are detected. So all co-pay does in reality is provide medical professionals with patients who are sicker when they come to see them and so start supplying more expensive (and profitable) units of medical care from the outset. There would be a temporary decline in healthcare usage while the level of sickness increases to the threshold and then the same or greater demand as before would ensue.

Patients are not free to leave the healthcare market. People who want to be healthcare providers are not free to enter the healthcare market. There can be no free market in healthcare. What don't you understand about this?

Could it? Can the NHS? Are you telling me there are NO denials? I don't believe you.

If a person needs a liver transplant, a liver is available and the person is deemed suitable based on medical criteria, they are not denied a liver transplant.

Yuppers. I want to spend my money on myself. I want you to spend your money on yourself. That way we all have incentives to control our costs. I don't want someone else spending my money on someone else. What am I getting for 38% of my hard earned income they already take out of my pocket? Try to suppress your emotional reaction.

A lot of nuclear weapons, a huge military and bankers awarding themselves bonuses.

And you don't understand the advantages of the free market. You've been marinated in a single-payer system for so long that you can't see past it.

No, I understand what an attempt to have a free market in healthcare would result in. It's not nice.

I'm trying to wrap my head around the advantages of a single-payer system and I do see a lot of people's points here. I'm reading as much as I can. But I don't like the way it devalues the skill-set that doctors have. Why are their life-saving skills worth less than a pop star? I also don't like the way the government system devalues educators. They are responsible for shaping our children's future, yet we pay them like trashmen. It's shameful, really that Britney Spears and her ilk live in mansions and party their lives away when the people that provide REAL VALUE to society are dismissed as greedy crooks.

You think the only way to value people is by their income or wealth?

 

[xjx388]

I don't know what healthcare you get for your 38%,

Absolutely zero.

but I'd be willing to bet it's less than I get for the 7.25%* I pay in tax and NI on my pitifully small salary.

Undoubtedly. Buy your government takes money from others to pay for the care of others. Me no likey.

Do you have medical insurance? Because if you do, you are certainly paying for other people. To make an effective comparison, you need to add the money you pay for insurance on to your tax burden.[/QUOTE]

As I said before, I have a catastrophic plan and a crapload of savings. I sacrifice luxuries to be able to save. The CP is a pooled-risk type deal, I understand, but much less so than a traditional plan.

 

[kellyb]

You assume that doctors will gouge because they know more than you do. That's left-wing propaganda: "Doctor's are greedy!"

I agree that that's "Democratic Party" propaganda (sort of, there's some element of truth to it, but the way it's marketed as THE reason for our health care woes seems like propaganda to me) but it's someing from the center-right think-tanks of the democratic party.) It's hardly "left wing" propaganda.

 

[Ducky]

There is no way you could have budgeted for your condition in our current system. I acknowledge this. But if it were a free market system and costs were lower, you might be able to. I never said you were irresponsible.

In a one-payer system, how is American society going to budget for your complex and high-cost health care?

So not only do you acknowledge your "catastrophic savings" ideas and your fiscal/personal irresponsibility arguments are bunk, you have no answer to solve the problem in the present. I see.

You do realize that health care cannot possibly be a free market, nor is it able to be treated as a free market, right? You've read the posts in this thread showing you that, yes?

You do understand that the more people included in an insurance system the payout costs needed are spread even more thin, yes? Why wouldn't we have the largest coverage pool possible and include the entire populace?

You also did not answer all of my questions. Here's one more:

How is it we are to encourage startup businesses if those starting one cannot possibly hope to have their business survive an illness?

The point above is that more market innovation and competition is a good thing. Stifling business opportunities due to medical catastrophe is not the way to achieve healthier economy.

But honestly, your arguments are coming down to valuation of a person based on their income. If I don't make enough to pay for my medical needs, then what, I should die or go bankrupt?

 

[kellyb]

As I said before, I have a catastrophic plan and a crapload of savings. I sacrifice luxuries to be able to save. The CP is a pooled-risk type deal, I understand, but much less so than a traditional plan.

So? Your money is being used by the insurance company to pay for other people's health care. You could drop dead and never get a dime back. OR, you could face a catastrophy and take more from that collectivist pool that you'll pay into it, at the expense of the folks who drop dead on the cheap.

So I think your real issue must be the voluntary nature of paying for private insurance vs taxation being involuntary.

 

[xjx388]

You think the only way to value people is by their income or wealth?

No. But our societies revolve around money. Money is the capital we use to assign value for each other's services. By paying the pop stars big money and the doctors and teachers squat, we are saying doctors are less valuable than pop stars. Thank you, but doctors don't work their tails off to succeed and provide immensely valuable services only to be told they are worth less than pop stars.

I see the same problem with CEOs vs. actual income-producers. The income disparity is ridiculous.

Pay people by their value to the business/society/etc.

 

[xjx388]

So? Your money is being used by the insurance company to pay for other people's health care. You could drop dead and never get a dime back. OR, you could face a catastrophy and take more from that collectivist pool that you'll pay into it, at the expense of the folks who drop dead on the cheap.

So I think your real issue must be the voluntary nature of paying for private insurance vs taxation being involuntary.

That's about the size of it. I can't go to jail for not paying my premium.

 

[kellyb]

But honestly, your arguments are coming down to valuation of a person based on their income. If I don't make enough to pay for my medical needs, then what, I should die or go bankrupt?

I think that would be a "yes".
In the mind of the conservative, death for the unworthy/unfortunate is morally better than endorsing theft "at gunpoint" via taxation.

 

[Agatha]

I'd be willing to bet it's less than I get for the 7.25%* I pay in tax and NI on my pitifully small salary.

Undoubtedly. Buy your government takes money from others to pay for the care of others. Me no likey.

So it's ok when insurance companies take money from others to pay for the care of others, PLUS bean counters, paper shufflers and the insurance company's bottom line, but not if the government does it without the profit element? Is this about healthcare or anti-government ideology?