Health care - administrative incompetence

Is the contention that there is no fraud in the private sector? Because when I googled there was a lot of stuff about bogus providers scamming private insurers and the private insurers turning to the government to deal with this by increased investigation and enforcement. I may be misunderstanding because the terms used are not familiar to me: but it looked like the private insurers were incapable of dealing with that kind of fraud and that it was quite widespread
 
Rolfe said:
I'm pretty sure they do.

In contrast to the NHS, where patients actually don't pay a brown penny.

And in which fraud appears to be entirely confined to the staff.

Rolfe.
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Rolfe, you are a smart person - surely you recognize that someone has to pay for medical services in your country. You guys are bandying about phrases like "it's free" and "don't pay a brown penny" but certainly you must know that nothing in life is free.
 
PDiGirolamo said:
Rolfe, you are a smart person - surely you recognize that someone has to pay for medical services in your country. You guys are bandying about phrases like "it's free" and "don't pay a brown penny" but certainly you must know that nothing in life is free.
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I'd rather pay less in overall GDP and get universal treatment, than pay more in GDP, and get a haphazard non universal crappy system. That's just me though.
 
Formal statistical investigation of comparative outcomes of different physicians or healthcare providers, with a view to identifying any which are performing below accepted standards.

Rolfe.
 
It is free at the point of use and this has been made plain again and again. If we have to keep making that clear we will: but by now I had assumed that we all knew what we we are talking about.
 
xjx388 said:
The reason fraud and abuse almost never happens is because of one simple mechanism: cost-sharing. In Medicare/Medicaid the patients don't pay a red cent.
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PDiGirolamo said:
Rolfe, you are a smart person - surely you recognize that someone has to pay for medical services in your country. You guys are bandying about phrases like "it's free" and "don't pay a brown penny" but certainly you must know that nothing in life is free.
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Gimme a break.

I pay my taxes. I pay them whether or not I use any NHS services. If I use any NHS services, I pay nothing extra.

This is free, to any normal definition of the term.

Rolfe.
 
Rolfe said:
Yes, of course you're on the side of the patients. But you're still an unnecessary overhead. You contribute nothing to actual patient care. You, and the people you correspond with, are equally parasites.

When there is no dispute that a patient is entitled to what their doctor agreed they should have, and the doctor is simply funded by a lump sum to look after the patients on his list, the whole thing just goes away.

Rolfe.
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So the NHS doesn't need people to mind the finances? I wonder ... Are these people parasites?
 
PDiGirolamo said:
Correct. But our current "free" market system pays them more than a universal system would, if Medicare and Medicaid are anything to go by.
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It's a hard comparison for a few reasons. One relevant problem is that if the MDs employed by Medicare/Medicaid are caring for patients who cannot afford care, they'd be earning $0 instead. These programs may be paying MDs for work that would not have otherwise existed.


In addition, one artefact that emerged in Canada was practitioners concluded that if they have one payor, they can collectively bargain. In each province, the Ministry negotiates with the Medical Association's Compensation Committee.

As another poster mentioned, there is also a much lower cost of operations for GPs in Canada. For some reason, we have dramatically lower malpractice rates, which means much lower malpractice insurance overhead. There's also the elimination of a huge amount of labour cost associated with paperwork.
 
One interesting thing I noticed about this thread: both the people who are arguing the strongest in favour of a privatised system are successful entrepreneurs. As such, they fall into an all too common logical fallacy for which I don't have an adequate name, but would describe as "argument from expertise."

What I mean is people who are experts at something are often surprised when it turns out not everyone is an expert at that same thing, and tend to chastise those people for their failures. Computer systems administrators (that's me) are surprised when people don't run anti-virus software and don't back up their systems. Financial experts are disappointed when not everyone puts a portion of their income into savings. I'm sure even Rolfe at times is surprised and disappointed by people who don't seem to know how to look after their pets or livestock.

And many entrepreneurs seem surprised by people who don't want to spend 16 hours a day, six or seven days a week, for years, often at great risk to their financial position, building up a business. And it seems to me the skills required to build a business are similar to the ones needed to build up a financial reserve and negotiate the minefield of private medical insurance: persistence, financial prudence, and a willingness to negotiate. And, perhaps, a willingness to spend hours and hours hunting for the best options and plans. In the case of catastrophic health insurance, a willingness to take the risk your family won't have a bad year.

I have news for the entrepreneurs: not everyone is like that. And to expect everyone to be like that is as silly as me expecting everyone to have a backup and a disaster recovery plan in place for every computer they own.
 
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When I think of the amount of time I don't spend thinking about how my future healthcare needs will be met, It absolutely amazes me.

(It amounts to s 10-minute conversation with the BUPA rep at BVA congress, during which he gave me some literature regarding premum rates negotiated for BVA members and tried to persuade me what a good idea it was, and me deciding that even though it wasn't a lot of money, why donate it to BUPA?)

Rolfe.
 
Bookitty: I see no difference. Every medical system needs people to see the patients, people to schedule the patients and people to deal with the money. In our system, the billing people like PD are a crucial piece of the puzzle. They are no more a parasite than the finance administrators in the NHS.
 
Blue Mountain said:
One interesting thing I noticed about this thread: both the people who are arguing the strongest in favour of a privatised system are successful entrepreneurs. As such, they fall into an all too common logical fallacy for which I don't have an adequate name, but would describe as "argument from expertise."

What I mean is people who are experts at something are often surprised when it turns out not everyone is an expert at that same thing, and tend to chastise those people for their failures. Computer systems administrators (that's me) are surprised when people don't run anti-virus software and don't back up their systems. Financial experts are disappointed when not everyone puts a portion of their income into savings. I'm sure even Rolfe at times is surprised and disappointed by people who don't seem to know how to look after their pets or livestock.

And many entrepreneurs seem surprised by people who don't want to spend 16 hours a day, six or seven days a week, for years, often at great risk to their financial position, building up a business. It seems the skills required to build a business are similar to the ones needed to build up a financial reserve and negotiate the minefield of private medical insurance: persistence, financial prudence, and a willingness to negotiate. And, perhaps, a willingness to spend hours and hours hunting for the best options and plans.

I have news for the entrepreneurs: not everyone is like that. And to expect everyone to be like that is as silly as me expecting everyone to have a backup and a disaster recovery plan in place for every computer they own.
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Yes, I think you are correct about entrepreneurs perhaps being a bit more protective of the fruits of their labor. After all, it represents an awful lot of sweat, blood, tears, missed vacations, and years' worth of sacrifices in addition to all those sucked-up hours. I don't care if people don't want to work 16 hours a day, seven days a week for years. But just because I do should not automatically entitle me to pay an exhorbitant amount of tax.

The posters on this thread fully believe the US should nationalize healthcare. While I believe the intent is admirable - to have everyone have access to healthcare - I also believe to place it in the hands of the government is potentially catastrophic. The US government is a TRILLION dollars in debt so it clearly cannot manage its money. It is full of corruption and backroom slimy deals amongst its leaders. To have it take over 1/6th of the economy seems insane to me.

I don't suppose any of us are inclined to change our views so on that note, this parasite is going to go finish the book she got for Christmas :) It has been an honor 'talking' to some of the posters on this thread, even if we disagree.

-P

P.S. And FWIW I do have active anti-virus and backups for EVERY computer I own!
 
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