Health care - administrative incompetence

xjx388 said:
Growing, harvesting, transporting and distributing food is very expensive.
Planning, obtaining materials, building and maintaining a home is very expensive.

People can't opt out of these markets; everyone needs both. Yet somehow, we are able to feed and shelter 99% of our 300,000,000+ people through the free market.

Give me specific reasons why healthcare is different and I can point to a way the free market might help.
Click to expand...

The difference is markets in food and shelter are free in the sense it's relatively easy for suppliers and consumers to enter and move around. Individual consumers in those markets have enough information to make reasonable choices and the ability to apply it when choosing which products to buy.

A market in healthcare cannot be free because in general individual consumers do not know enough to make reasonable choices about what type of healthcare services represent the best deal for them, or are in no condition to be able to make such a choice.
 
Ivor the Engineer said:
The difference is markets in food and shelter are free in the sense it's relatively easy for suppliers and consumers to enter and move around. Individual consumers in those markets have enough information to make reasonable choices and the ability to apply it when choosing which products to buy.
Click to expand...

Same deal with optional, non-emergent medical stuff like Lasik and cosmetic surgery.
 
Ivor the Engineer said:
The difference is markets in food and shelter are free in the sense it's relatively easy for suppliers and consumers to enter and move around. Individual consumers in those markets have enough information to make reasonable choices and the ability to apply it when choosing which products to buy.

A market in healthcare cannot be free because in general individual consumers do not know enough to make reasonable choices about what type of healthcare services represent the best deal for them, or are in no condition to be able to make such a choice.
Click to expand...

Or, some of them are completely unable to foresee, budget for, or afford the proper care they need even with private insurance.

As Rolfe pointed out earlier, no amount of shopping around gets me an affordable porsche, yet that is what I needed to repair my spine and get treatment.
 
xjx388 said:
Speak honestly now: If the NHS is so Universally Loved in the UK, then how can David Cameron even have a plank of his platform about "hiving off the NHS to the private sector?" It should be political suicide, no? Yet somehow, he's the Prime Minister . . . :confused:

:
Click to expand...

Labour was voted out because of what happened with Tony Blair and the Iraq war and the whole WMD mess that was revealed.

I don't think that the Tories are going to get another go.

xjx388 said:
And the results of the last election show that the American people agree with them.

The private sector works to distribute the two fundamental human needs 1)Food and 2)Shelter. In healthcare markets that are completely private sector: 1)Vetrinary medicine, 2)Lasik, 3)Cosmetic surgery and 4)Self-pay primary care, it works just fine.
Click to expand...

I assert you are policitally naive.

Presidents who win by a significant majority always lose seats in the primaries, it also happened to Regan.

I think the votes represent the disappointment that Obama didn't change as much as he campaigned on.

Yes, private sector and cheap plastic or eye surgery.


What a win-win. :rolleyes:
We have that already, it is all too often a complete disaster.

You haven't provided any good evidence that self-pay primary care works.
 
Ducky said:
Or, some of them are completely unable to foresee, budget for, or afford the proper care they need even with private insurance.

As Rolfe pointed out earlier, no amount of shopping around gets me an affordable porsche, yet that is what I needed to repair my spine and get treatment.
Click to expand...

I think the idea is that with people like you "opting out of the market", the market will bring the price down to a level affordable to people like xjx.
 
xjx388 said:
...snip...

Speak honestly now: If the NHS is so Universally Loved in the UK, then how can David Cameron even have a plank of his platform about "hiving off the NHS to the private sector?" It should be political suicide, no? Yet somehow, he's the Prime Minister . . . :confused:

...snip...
Click to expand...

You've got that bit wrong - his platform was that the NHS would be safe in his hands and there would not be "constant reorganisation". Rolfe was commenting that true to form for his party they will try to hive more and more of the NHS to the party donors, sorry the "free market".
 
Tatyana said:
Labour was voted out because of what happened with Tony Blair and the Iraq war and the whole WMD mess that was revealed.

I don't think that the Tories are going to get another go.

...snip...
Click to expand...

It was a strange election - one of the most unpopular PMs in recent times and still the Tories couldn't win the election.
 
It's quite clear that xjx388 is either unable or unwilling to keep multiple concepts in his head at one time. It's like playing a game of whack-a-mole. What does it matter of UK citizens are a little frustrated with NHS? The simple fact of the matter is that if the NHS gives you high blood pressure, it's covered. In the USA, we're more frustrated with health care, and our high blood pressure treatment comes out of pocket, assuming you have something in your pockets.

Simply put, xjx388 doesn't want it based on general principles. His posts are little more than uninformed rationalizations to justify an ideology. His only attempt at actually addressing his ideology is to say, "It's not a right" as if that has any meaning at all. Universal health care is not prohibited by the Constitution, so any talk of "rights" is meaningless. The real and only question is this:

Why not?
 
Rolfe said:
How you imagine a universal healthcare system could be implemented without it being paid for at least to some extent by the govermnent, I have no idea. Feel free to elaborate though.
Click to expand...

I can't imagine a single payer-system that is not run by the government; therefore, I don't want one.

I realize that the government has to have a role in regulating some aspects of healthcare to make it fairer for patients and doctors alike. But they don't have to be the payer. Govt. can:
  • Fund subsidies/vouchers for low-income people to obtain private health insurance
  • Make it illegal to deny coverage for pre-exisiting conditions
  • Make it illegal to drop coverage because of increased risk
And doing so will make healthcare more universal without the government having a say in everyone's healthcare.
 
Darat said:
You've got that bit wrong - his platform was that the NHS would be safe in his hands and there would not be "constant reorganisation". Rolfe was commenting that true to form for his party they will try to hive more and more of the NHS to the party donors, sorry the "free market".
Click to expand...

Yes, very much this. There were billboards all over the country with David Camerons face on them, with the quote "I'll cut the defecit, not the NHS". It should be telling that even the right wing british party, with the majority of media backing, still had to declare that it wouldn't touch the british UHC system as its main point of campaigning (I voted Labour, for the record). We like our NHS.

Of course, it turns out he was lying and in real terms they are cutting the NHS, but thats par for the tory course.
 
Tatyana said:
You haven't provided any good evidence that self-pay primary care works.
Click to expand...

It works well for some things. In my city there's a FP practice that caters to our immigrant population who often have to self-pay. What they can offer is limited (they don't do oncology, for example) but they do offer a lot of services at a relatively cheap price.
 
xjx388 said:
It's not that the government can't manage healthcare reasonably well. It's that 1)The American people don't want the government managing it
Click to expand...

FALSE! When pollsters asked if Americans if they would like a programme described as "Medicare for all" (the equivalent of NHS), the majority thought that would be brilliant.

2)The private sector can manage it much better
Click to expand...

FALSE! The Private Sector (US Health Insurers) have demonstrated categorically that not only CAN'T they manage it much better but that they WON'T because it cuts into their profits.

Speak honestly now: If the NHS is so Universally Loved in the UK, then how can David Cameron even have a plank of his platform about "hiving off the NHS to the private sector?" It should be political suicide, no? Yet somehow, he's the Prime Minister . . . :confused:
Click to expand...

FALSE! Every party in the last elections promised the NHS would not be touched. Many Lib Dems and even some Conservatives are appalled by the about face.

GB
 
Last edited:
xjx388, are you going to comment on my cost estimates demonstrating that high-tech medical treatment is inherently expensive? (You said that the numbers were made up and referred to the current system, so I guess you have an idea what *your* numbers would be).

post #817 shows that my estimates are conservative, and the real cost of supplying a complex surgical procedure (a 5-hour coronary bypass) would be significantly higher than my calculations.

The numbers are sufficiently robust that they are not just made up, but I would like some feedback from anyone with medical experience demonstrating where my assumptions are wrong (either too low or too high).

How long can a surgeon actually be in theatre, operating per week? What wage should this surgeon need? How much for the anaesthetist? And the support staff? What about the utilisation of the operating theatre? How long should you need to amortise the capital cost of the theatre over?

Now how can someone with 20004 median household net worth of $4000 pay for this without support?
 
Last edited:
kellyb said:
It works well for some things. In my city there's a FP practice that caters to our immigrant population who often have to self-pay. What they can offer is limited (they don't do oncology, for example) but they do offer a lot of services at a relatively cheap price.
Click to expand...

Exactly. We have a substantial self-pay population. We're able to offer them services within our scope of practice at very affordable rates. These people aren't just immigrants; they are the working uninsured for the most part. We can't do cancer surgery, but we can do quite a bit.

You'd also be amazed at what our local physician-owned hospital provides in the way of heavily discounted (sometimes pro bono) services to these uninsured people.

It can be done, people. It really can. If, I'm filtering your comments through my ideology then you are doing the same.
 
And for expensive,chronic illnesses? How much of that should be funded pro bono? Private, profit-making organisations should fund expensive courses of treatment for the public good?

You think the government can't supply care effectively, but that charity can?
 
I retooled the last paragraph of this but I'm posting here a private message I sent to Rolfe. She suggested sharing it with you fine folk.

Obviously I don't post much but I've been lurking here for four years or so. I have Duchenne muscular dystrophy. I am one of the few lucky people who made it past my 25th birthday. Former actor Jerry Lewis runs a private telethon in Los Angeles every year while smaller metropolitans have their own local drives. Something that scares me is what seems like a lack of interest in relatively rare diseases because fighting an illness such as this is seen as a luxury. The only way to pay for it is to shell out money people like us don't have.

I must say I have a pretty poor quality of life. I'm on my computer most of the day. I don't have a van that's appropriate for the present state of my condition and despite there being home care agencies out there paid for by Medicaid, they are generally poorly-run organizations. They don't have the money to hire people who actually care about the disabled folk they're aiding. I have working parents, really the only people I feel comfortable with caring for me. In five years I've probably lost about ten friends to this. In 1998 I had to deal with my brother's death as he also had this disease.

I have an enlarged heart and I'm currently on an ACE inhibitor and a statin, your bread-and-butter reliable medicines. Many people with DMD are prescribed steroids to combat the wasting away of the muscles, which really taxes their already compromised heart. Given how our medical field has gone the past forty years in the United States, I feel like finding treatments for this disease have been retarded. We are behind in innovation but there's no reason why out of 330 million people we can't find solutions.

There's just no money in it.

All this crap about charity being enough makes me laugh. They go to popular causes, some of which are admittedly fairly deserved, but those are a minority. I am tired of people with chronic illnesses like me being treated like second-class citizens, like leeches on the rich. I have a pre-existing condition and it enrages me when people just don't understand that while they're chasing their vaguely-defined embodiment of liberty, there's a segment of the population that is suffering, not only physically but emotionally. I have a struggle every day with mood swings. I've thought about suicide more than somebody should and I feel like I'm cracking more and more every day.

I think people would be more willing to do the things we're discussing if there were an awareness of the amount of suffering going on. Apparently people don't think that many are dying in and because of debt, thanks to this system.
 
Last edited:
xjx388 said:
Exactly. We have a substantial self-pay population. We're able to offer them services within our scope of practice at very affordable rates. These people aren't just immigrants; they are the working uninsured for the most part. We can't do cancer surgery, but we can do quite a bit.

You'd also be amazed at what our local physician-owned hospital provides in the way of heavily discounted (sometimes pro bono) services to these uninsured people.

It can be done, people. It really can. If, I'm filtering your comments through my ideology then you are doing the same.
Click to expand...

Yeah, it works for the health care equivalent of a used 1995 Kia. When you need the health care equivalent of new Porsche, you're into the world of health care "niche markets", though.

Do you understand this?
 
You must log in or register to reply here.

Back
Top Bottom