Health care - administrative incompetence

[bookitty]

Perhaps all Doctors in the US will move to other fields if they are forced to get paid for everyone they have to treat?

Yes, or, and I'm totally blue-skying here, but let's say we used the current cost of US health care to cover a universal plan. Insurance rates go down. A few more families have the money to send their kid to college. Colleges that are subsidized by the government in order to expand the number of doctors available. These kids graduate as doctors without the ridiculous burden of school loans. Those doctors while making a bit less than the doctors of 10 years prior, have fewer bills and so have the same amount of net income.

And with more doctors and better access to preventative care, the cost of providing health coverage is reduced because there are far less people abusing the emergency wards because they haven't got coverage. And then we could take that savings and invest it in more doctors.

Yes, it's crazy. Yes, I'm an evil librul red comrade commie for even suggesting such a thing.

 

[Tatyana]

Childish, because taxes are not theft, however excessive.

I really wish you guys would get your stories straight. Over on another thread, BaC is telling us all how bad we have it in Britain because of the stonking amounts of tax we pay, while he's free as air because Americans pay less.

I think xjx388 took the same line in this thread too.

So which is it? Are you taxed till your pips squeak and can't possibly afford any more, or is it the central pillar of America as a free society that you have lower taxes than in commie Europe?

Rolfe.

xjx has claimed he pays 10% of his wages in taxes, total.

I believe that is the property tax rate, plus or minus 0.5%.

 

[kellyb]

xjx has claimed he pays 10% of his wages in taxes, total.

I believe that is the property tax rate, plus or minus 0.5%.

No, that was Agatha that said that. xjx just messed up when quoting her.

 

[Rolfe]

Ahh.. You think that the lives of other people are unimportant, next to doctors getting paid what you feel they should be paid.

Tell me, why do doctors in, pretty much the rest of the world, still manage to do well despite the entire population getting the care they need.

You sicken me.

Bear in mind that xjx388 was lucky enough to be able to marry his (pregnant) teenage sweetheart, who turned out to be quite bright, and managed to qualify as a doctor.

We don't know that he himself has any higher educational qualifications at all, but he has a cushy little job as an administrator in her medical practice.

He appears to be living off the medical "industry", by way of his marital connection. Thus his preoccupation with film-star-size incomes for doctors is perhaps understandable.

Rolfe.

 

[MatildaGage]

Is it your position that it is acceptable for people born into poverty, people with lifelong chronic illnesses, people with rare cancers, people with early onset ALS (etc) to be denied care by the free market on the grounds that they do not and will never have the means to pay for their care?

I used to argue this point, assuming no one would actually take that position.

I got arrogant smirks in response, and statements that yes, they think people like that should not get expensive care, even if it means they will die.

Again I must point out, these are the same people who promote having lots of babies regardless of the risk of them being born with the same expensive conditions. Making new baby Xians fits with their religious beliefs and personal desires, which makes it ok, whereas "paying for other people's medical bills" does not.

My reason for bringing this up is to point out the total lack of logic and ethics. You can't have it both ways. You're not a very good Christian or a very good person if you encourage people to produce lots of babies who will then be left to suffer or die. It's fine though, they'll go to Heaven.

Because, as we all know, Jesus fathered many children and didn't believe in healing.

 

[Rolfe]

I'm not sure that I believe xjx is in the 38% federal tax bracket, though.

His wife might be though. And he might be if they're pulling a tax avoidance trick to maximise his lower-tax-rate allowances. He has previously nade financial claims that are completely impenetrable because he conflated his income with his wife's.

Rolfe.

 

[kellyb]

His wife might be though. And he might be if they're pulling a tax avoidance trick to maximise his lower-tax-rate allowances. He has previously nade financial claims that are completely impenetrable because he conflated his income with his wife's.

Rolfe.

But I'm pretty sure the very top federal tax bracket is 35%.

 

[jimbob]

But I'm pretty sure the very top federal tax bracket is 35%.

Ah...

 

[Emet]

That second quote was really from Agatha. Xjx just messed up where he placed the quote bracket.

I'm not sure that I believe xjx is in the 38% federal tax bracket, though.

Okay, thanks. Perhaps folks might preview their posts--might save some time.

Tax brackets ( I have to learn how to make tables ):

http://moneysmartlife.com/2010-federal-income-tax-brackets/

 

[FattyCatty]

Do we, as a society, have a duty to protect those who are most vulnerable?

Moreover, your existing crappy system costs double what ours does, and for that we treat absolutely everybody - to standards comparable with your own.

You're being taken for a mug mate.

Civilized societies have a duty to protect those who are most vulnerable. A sad American has to agree with you that we fail at this.

Not our country, but the way our government (and any government really) has botched public health care, education, defense spending, etc. America is, despite it's problems, still the greatest country in the world.

Obviously, this is not true with regard to health care. While the US private-sector, for-profit health insurance companies have failed America's citizens, the governments of other countries have not failed theirs.

Which means that, if not for people like you, the US could turn around and provide health care to all Americans. And I disagree that the government has butchered health care, other than the lack of regulation of the health insurance industry. Medicare and the VA run more efficiently than for-profit insurance (as shown previously in this thread). Any horror stories from dealing with government bureaucracy can be more than matched with horror stories dealing with non-government insurance companies.

Simplifying administration under one system would save money that could be spent on actual health care, instead of the amounts spent figuring out the many different systems and requirements that currently exist.

As for your "pro bono" picking up of the slack, according to The Kaiser Commission on Medicaid and the Uninsured, it doesn't happen often:

Most of the uninsured do not receive health services for free or at reduced charge. Hospitals frequently charge uninsured patients two to four times what health insurers and public programs actually pay for hospital services.[SUP]30[/SUP] Slightly less than half of the uninsured know of a provider in their community who charges less to patients without insurance.³¹ Only about one quarter of low-income uninsured adults (those with incomes under twice the poverty level) report that they have received care for free or at reduced rates in the past year.³²
The uninsured are increasingly paying "up front" before services will be rendered. When the uninsured are unable to pay the full medical bill in cash at the time of service, they can sometimes negotiate a payment schedule with a provider, pay with credit cards (typically with high interest rates), or can be turned away.³³
Being uninsured leaves individuals at an increased risk of amassing unaffordable medical bills. Uninsured adults are three times as likely as the insured to have been unable to pay for basic necessities such as housing or food due to medical bills (Figure 12). Medical bills may also force uninsured adults to exhaust their savings. In 2010, 27% of uninsured adults used up all or most of their savings paying medical bills.

 

[Rolfe]

Okay, thanks. Perhaps folks might preview their posts--might save some time.

Tax brackets ( I have to learn how to make tables ):

http://moneysmartlife.com/2010-federal-income-tax-brackets/

You have to think about more than income tax though. Maybe these tables of how long the average person has to work before they've paid all the tax they will pay in the year would be better. Though that will only give you an average for the country.

Tax is irrelevant anyway. We both pay about the same amount in tax to fund government-provided healthcare. It's just that Americans don't get anything for it, and we do.

Rolfe.

 

[Emet]

And with all the whining about government run health care in the US (yes it has problems, especially Medicaid and the VA), Medicare folks are pretty satisfied:

Meeting Enrollees' Needs: How Do Medicare and Employer Coverage Stack Up?
May 12, 2009

Synopsis
In a national Commonwealth Fund survey, elderly Medicare beneficiaries reported greater overall satisfaction with their health coverage, better access to care, and fewer problems paying medical bills than people covered by employer-sponsored plans. The findings bolster the argument that offering a public insurance plan similar to Medicare to the under-65 population has the potential to improve access and reduce costs.

http://www.commonwealthfund.org/Con...erature/2009/May/Meeting-Enrollees-Needs.aspx

 

[Emet]

You have to think about more than income tax though. Maybe these tables of how long the average person has to work before they've paid all the tax they will pay in the year would be better. Though that will only give you an average for the country.

Tax is irrelevant anyway. We both pay about the same amount in tax to fund government-provided healthcare. It's just that Americans don't get anything for it, and we do.

Rolfe.

Yes, I agree. But I'll thank you to stop telling me how good things are in the UK. It makes me want to move. I'm a vet--am I employable? Can I emigrate? How do y'all feel about non-English speakers? (I speak American)
And how's the weather?

 

[Tatyana]

You have to think about more than income tax though. Maybe these tables of how long the average person has to work before they've paid all the tax they will pay in the year would be better. Though that will only give you an average for the country.

Tax is irrelevant anyway. We both pay about the same amount in tax to fund government-provided healthcare. It's just that Americans don't get anything for it, and we do.

Rolfe.

As well, most Americans don't get very much or any paid annual leave either.



I will stop with the annual leave comments when BeAChooser and xjx tell me how much paid leave they get each year.

 

[Rolfe]

Yes, I agree. But I'll thank you to stop telling me how good things are in the UK. It makes me want to move. I'm a vet--am I employable? Can I emigrate? How do y'all feel about non-English speakers? (I speak American)
And how's the weather?

Very employable. But you have to get registered with the RCVS first. If you qualified from a university conferring a recognised degree then that will do it, but I don't have a list of such universities to hand. Otherwise you have to sit the RCVS entrance exam. This should be a breeze for anyone who qualified fairly recently from any decent university.

American will do it. I've worked with Spanish and Portuguese vets recently, and we just took on a German one, you'd be fine.

Jobs, depends on your speciality. I know some of the Portuguese guys had trouble moving out of meat inspection, which is the usual way in (it's a legal requirement that meat has to be inspected by a vet and not that many of us locals want the job). But if you have a desirable postgraduate speciality, then easy. (The Portuguese guy did get a small animal surgery job in the end.)

Right now, the weather is lots of snow in the process of melting. Depends what you want. I like it!

Rolfe.

 

[Tatyana]

Yes, I agree. But I'll thank you to stop telling me how good things are in the UK. It makes me want to move. I'm a vet--am I employable? Can I emigrate? How do y'all feel about non-English speakers? (I speak American)
And how's the weather?

Meh.

You get used to it, and of course, you can talk about it all the time as it is constantly changing.

 

[Fiona]

I would like to ask the Americans who are unhappy with the current situation if it was always like this in America. I ask because upthread someone said they saw the origin of the problem in the Reagan years. As others have mentioned, we in the uk are currently seeing active threat to the health service, although the government making that threat lied about their intentions in order to get elected (IMO). To me this seems to be yet another step along a road which has been travelled since the Thatcher years and there is a tendency to see this as americanisation (a tendency I often fall into). Yet it seems to me that that is a misnomer and that what we are seeing is not nationally based at all. It is rather a change in the nature of government from democracy to plutocracy, though unacknowledged. I think that move is further advanced in America, perhaps because they started earlier; or because it fits better with the national narrative; or for some other reason. I understand from some other europeans that the move is also happening in some other countries though they are maybe less far down the road than we are. It is at least noticeable that some premises which are eminently challengeable are treated as fact and that the debate has become limited in terms of what is seen as reasonable to discuss. Perhaps the phenomenon is truly american, as it is often seen: but perhaps it is no more american than it is british or european: but is rather transnational because plutocrats have more interests in common with each other than they do with nations or populations. Sorry if that is derail but I am interested in how this woo developed and gained ascendancy

 

[Rolfe]

Dunno. Time I went to bed.

I'm a big fan of universal benefits. It's fair, because the better-off have paid the greater amount of tax into the system, so it's inequitable to exclude them from benefits. It's efficient, because it saves a helluva lot of admin to figure out who's eligible. And it's friendly and egalitarian, because it does away with the "them and us" stigma.

Liberals used to be big on this one. Not now though I fear.

We're seeing more and more of the "oh why should these people get that benefit, they don't need it." It's divisive, and it's unfair. And at the other end it's "patients should pay a contribution." No, why the hell should they, they're the ones who had the bad luck to get sick.

I think we need to re-think our whole attitude to tax, and realise that it's our contribution to building a society worth living in.

That, and hang all the bankers.

Rolfe.

 

[Fiona]

Dunno. Time I went to bed.

I'm a big fan of universal benefits. It's fair, because the better-off have paid the greater amount of tax into the system, so it's inequitable to exclude them from benefits. It's efficient, because it saves a helluva lot of admin to figure out who's eligible. And it's friendly and egalitarian, because it does away with the "them and us" stigma.

Liberals used to be big on this one. Not now though I fear.

We're seeing more and more of the "oh why should these people get that benefit, they don't need it." It's divisive, and it's unfair. And at the other end it's "patients should pay a contribution." No, why the hell should they, they're the ones who had the bad luck to get sick.

I think we need to re-think our whole attitude to tax, and realise that it's our contribution to building a society worth living in.

That, and hang all the bankers.

Rolfe.

Agreed.

 

[kellyb]

I would like to ask the Americans who are unhappy with the current situation if it was always like this in America. I ask because upthread someone said they saw the origin of the problem in the Reagan years. As others have mentioned, we in the uk are currently seeing active threat to the health service, although the government making that threat lied about their intentions in order to get elected (IMO). To me this seems to be yet another step along a road which has been travelled since the Thatcher years and there is a tendency to see this as americanisation (a tendency I often fall into). Yet it seems to me that that is a misnomer and that what we are seeing is not nationally based at all. It is rather a change in the nature of government from democracy to plutocracy, though unacknowledged. I think that move is further advanced in America, perhaps because they started earlier; or because it fits better with the national narrative; or for some other reason. I understand from some other europeans that the move is also happening in some other countries though they are maybe less far down the road than we are. It is at least noticeable that some premises which are eminently challengeable are treated as fact and that the debate has become limited in terms of what is seen as reasonable to discuss. Perhaps the phenomenon is truly american, as it is often seen: but perhaps it is no more american than it is british or european: but is rather transnational because plutocrats have more interests in common with each other than they do with nations or populations. Sorry if that is derail but I am interested in how this woo developed and gained ascendancy

No, it wasn't always like this.
The force, IMO, is the international finance industry/FIRE sector.

I suggest poking around this website:

http://michael-hudson.com/

The author is an economist who has advised left wing US presidential candidates, and multiple governments globally.