Merged "Bitter Pill": Major article on US expensive healthcare (Time)

[WildCat]

And if you get insurance through your employer, and you become too sick to work, you lose the insurance. You can extend it with COBRA...for a lot more money than you were paying. And of course now you're not working you can't really afford what you were paying before, much less more...

As long as health insurance comes through employers, people are not secure because both your insurance and income eggs are in the same basket.

I'm on the record here of being against employer-provided health care for that very reason.

If I had my way I'd make it go away by taxing health benefits as income and not allowing employers to deduct it as a business expense. This would also help level the playing field between large and small companies, as well as improve the competitiveness of US companies overseas.

 

[elbe]

I pay $5 for most generic prescriptions.

The fact is for many Americans, hundreds of millions of us infact or around 90% of our population, our healthcare system works just fine.

I'm one of those people who the health care system is "working" for (quite a bit, recently, with gallbladder surgery scheduled this week), but it's the most incompetent, inefficient system I've ever seen. So maybe "just fine" isn't good enough for the kind of money I, and my employer, spend on it.

 

[TragicMonkey]

I'm on the record here of being against employer-provided health care for that very reason.

If I had my way I'd make it go away by taxing health benefits as income and not allowing employers to deduct it as a business expense. This would also help level the playing field between large and small companies, as well as improve the competitiveness of US companies overseas.

I'm against insurance entirely. It's a scam. In order to work, it has to take in more than it pays out. We have a situation where some people are paying for potential costs that may never occur. I'd rather everybody pay for everybody's actual costs that do occur. I've paid thousands in insurance without getting sick. If I lose my insurance tomorrow and get sick, boy would those thousands come in handy. But I spent them all already on not being sick.

Just cover everybody's medical expenses when they occur, and pay for it via taxing everybody. Since everybody's paying in, and everything gets paid for, there's less waste--nobody paying for not receiving healthcare, nobody left unable to pay for healthcare they need.

 

[jimbob]

I'm against insurance entirely. It's a scam. In order to work, it has to take in more than it pays out. We have a situation where some people are paying for potential costs that may never occur. I'd rather everybody pay for everybody's actual costs that do occur. I've paid thousands in insurance without getting sick. If I lose my insurance tomorrow and get sick, boy would those thousands come in handy. But I spent them all already on not being sick.

Just cover everybody's medical expenses when they occur, and pay for it via taxing everybody. Since everybody's paying in, and everything gets paid for, there's less waste--nobody paying for not receiving healthcare, nobody left unable to pay for healthcare they need.

Indeed - as soon as one considers it as a public good, the equation changes.

 

[WildCat]

I'm against insurance entirely. It's a scam. In order to work, it has to take in more than it pays out. We have a situation where some people are paying for potential costs that may never occur. I'd rather everybody pay for everybody's actual costs that do occur. I've paid thousands in insurance without getting sick. If I lose my insurance tomorrow and get sick, boy would those thousands come in handy. But I spent them all already on not being sick.

Just cover everybody's medical expenses when they occur, and pay for it via taxing everybody. Since everybody's paying in, and everything gets paid for, there's less waste--nobody paying for not receiving healthcare, nobody left unable to pay for healthcare they need.

Except that does absolutely nothing to bring down the costs hilited in the article linked in the OP.

US doctors, nurses, hospital administrators, pharmaceutical sale reps, everyone involved in health care in the US makes far more money than they do anywhere else. There is little price competition among health care providers, just try figuring out how much this hospital charges for a given procedure versus that hospital. Indeed, in Illinois the government has a hospital board whose primary purpose is ensuring that no hospital competes with another hospital. To open a new hospital you have to spend gobs of money and years of time convincing the hospital board that the new hospital is needed and won't take patients away from existing hospitals. It's unreal, frankly states should be relieved of all authority to regulate health care IMHO since they do it so irresponsibly.

 

[TragicMonkey]

Except that does absolutely nothing to bring down the costs hilited in the article linked in the OP.

Oh, okay then, let's continue burning money in the fireplace while we talk about the wisdom of burning it on the front lawn as well.

US doctors, nurses, hospital administrators, pharmaceutical sale reps, everyone involved in health care in the US makes far more money than they do anywhere else.

Really? How much money do you think I ought to make? I'm in IT, support for four applications at nine hospitals. I also write reports and test software implementation. I work about sixty hours a week, and am on call 24/7/365. Please tell me what my salary ought to be. I'm interested in hearing it.

There is little price competition among health care providers, just try figuring out how much this hospital charges for a given procedure versus that hospital. Indeed, in Illinois the government has a hospital board whose primary purpose is ensuring that no hospital competes with another hospital. To open a new hospital you have to spend gobs of money and years of time convincing the hospital board that the new hospital is needed and won't take patients away from existing hospitals. It's unreal, frankly states should be relieved of all authority to regulate health care IMHO since they do it so irresponsibly.

You want a Walmart type hospital to open, low low prices, drive all the others out of business, then jack up their prices once they're the only game in town? Healthcare is sometimes regulated precisely because it's not the same as other businesses. You don't want life and death controlled solely by market forces.

 

[Nessie]

Is it right to say that the problem is the gap in the middle where people cannot get aid and cannot afford insurance that will cover all bills?

If so, how many people are in that gap?

 

[maxpower1227]

I'm about 18 pages into this monster of an article, and I almost want to just move to Canada now rather than finish reading it. Why do we as a nation put up with this insanity?

 

[jimbob]

I'm about 18 pages into this monster of an article, and I almost want to just move to Canada now rather than finish reading it. Why do we as a nation put up with this insanity?

There is a lot of propaganda in the US media, some of it laughable to those of us in the rest of the OECD. Remember the claim that if Stephen Hawking were British, he'd not have survived due to NHS death panels...

 

[Travis]

I'm on the record here of being against employer-provided health care for that very reason.

If I had my way I'd make it go away by taxing health benefits as income and not allowing employers to deduct it as a business expense. This would also help level the playing field between large and small companies, as well as improve the competitiveness of US companies overseas.

I'm against insurance entirely. It's a scam. In order to work, it has to take in more than it pays out. We have a situation where some people are paying for potential costs that may never occur. I'd rather everybody pay for everybody's actual costs that do occur. I've paid thousands in insurance without getting sick. If I lose my insurance tomorrow and get sick, boy would those thousands come in handy. But I spent them all already on not being sick.

Just cover everybody's medical expenses when they occur, and pay for it via taxing everybody. Since everybody's paying in, and everything gets paid for, there's less waste--nobody paying for not receiving healthcare, nobody left unable to pay for healthcare they need.

Well other countries seem to be able to keep costs down. Surely America won't be the only one that is unable to once we go to a universal system.

There is a lot of propaganda in the US media, some of it laughable to those of us in the rest of the OECD. Remember the claim that if Stephen Hawking were British, he'd not have survived due to NHS death panels...

Don't forget that Santorum was spreading the story that the Dutch just kill their old people when they hit a certain age. He left out if runes that change color with age were involved.

 

[WildCat]

Oh, okay then, let's continue burning money in the fireplace while we talk about the wisdom of burning it on the front lawn as well.



Really? How much money do you think I ought to make? I'm in IT, support for four applications at nine hospitals. I also write reports and test software implementation. I work about sixty hours a week, and am on call 24/7/365. Please tell me what my salary ought to be. I'm interested in hearing it.

Man, how people in the health care industry deny they're part of the problem. It's everyone else driving up costs, right? Oh look, there's the insurance bogeyman! US health care is the most expensive in the world in large part because we pay health care workers more than any other country. Now you may claim you're somehow worth far more than your equivalent in the UK or France, but you certainly can't claim those workers make the same as their US counterparts.

You want a Walmart type hospital to open, low low prices, drive all the others out of business, then jack up their prices once they're the only game in town? Healthcare is sometimes regulated precisely because it's not the same as other businesses. You don't want life and death controlled solely by market forces.

Walmart is already doing great things with prescription prices, I'd love to see them drive down other costs as well. And I'm unaware of them jacking up prices once "they're the only game in town". If they did Target or Kmart or someone would just come in and undercut them.

I wish I could say the same about hospitals here in Illinois, but our state legislature in their wisdom have determined that hospitals should have no competition.

 

[xjx388]

Man, how people in the health care industry deny they're part of the problem. It's everyone else driving up costs, right? Oh look, there's the insurance bogeyman! US health care is the most expensive in the world in large part because we pay health care workers more than any other country. Now you may claim you're somehow worth far more than your equivalent in the UK or France, but you certainly can't claim those workers make the same as their US counterparts.

Providers in the US definitely get paid more than anywhere else in the world. So? If medicine is such a vital thing that everyone should be entitled to it and its such a difficult subject to master, doesn't it make sense that those who dedicate their lives and spend considerable money to get trained should be paid accordingly?

If you want the best and brightest being doctors -and you really really should- then you want those people to have an incentive to enter medicine. Otherwise, they'll become engineers, lawyers and anything more lucrative than being a doctor.

 

[monty1]

Walmart is already doing great things with prescription prices, I'd love to see them drive down other costs as well. And I'm unaware of them jacking up prices once "they're the only game in town". If they did Target or Kmart or someone would just come in and undercut them.

I wish I could say the same about hospitals here in Illinois, but our state legislature in their wisdom have determined that hospitals should have no competition.[/QUOTE]

Come to Canada and buy a bunch to take home. They're a lot cheaper and they will let you get some back across the border. We care about Americans who can't afford the medications they need.

And btw, they're all made by the big names.*

*they're really counterfeit meds which are made especially for Canadian suckers

 

[TragicMonkey]

Man, how people in the health care industry deny they're part of the problem. It's everyone else driving up costs, right? Oh look, there's the insurance bogeyman! US health care is the most expensive in the world in large part because we pay health care workers more than any other country. Now you may claim you're somehow worth far more than your equivalent in the UK or France, but you certainly can't claim those workers make the same as their US counterparts.

I didn't make any claims about my worth or other people's salaries. You did. You said I make too much money. Please tell me how much money you think I ought to make. Go on. You know all the answers. What should my salary be?

 

[WildCat]

Providers in the US definitely get paid more than anywhere else in the world. So? If medicine is such a vital thing that everyone should be entitled to it and its such a difficult subject to master, doesn't it make sense that those who dedicate their lives and spend considerable money to get trained should be paid accordingly?

If you want the best and brightest being doctors -and you really really should- then you want those people to have an incentive to enter medicine. Otherwise, they'll become engineers, lawyers and anything more lucrative than being a doctor.

And when you price yourselves such that only government can afford to pay you, don't be surprised when govenrment eventually gives you a pay cut.

If you don't like it go drive a truck or something. Health care isn't just for the rich, and health workers shouldn;t be in it for the money.

I've proposed, for example, that government pay to educate doctors and nurses. In return, they work for 25 years or so at a reduced salary so we can afford to actually treat sick people. Think of all the qualified people now who can't afford medical school, that door will be open to them. And rich people looking to become richer can become something else besides doctors.

 

[WildCat]

I didn't make any claims about my worth or other people's salaries. You did. You said I make too much money. Please tell me how much money you think I ought to make. Go on. You know all the answers. What should my salary be?

I said that US health care workers pay should be more commensurate with what their pay is in other first world western countries.

If you don't like it find another career, we can't afford to pay twice as much as other countries for health care.

 

[TragicMonkey]

Oh, I see. You think the healthcare industry only employs doctors. Much the same way the movie industry only employs actors.

Why, its almost as if you're demonstrating you know very little about the industry you're pontificating about!

 

[TragicMonkey]

I said that US health care workers pay should be more commensurate with what their pay is in other first world western countries.

If you don't like it find another career, we can't afford to pay twice as much as other countries for health care.

You think I'm earning double what my counterparts ate elsewhere? I looked it up. They're paying the same in France for my job, and more in the UK.

 

[WildCat]

Oh, I see. You think the healthcare industry only employs doctors. Much the same way the movie industry only employs actors.

Why, its almost as if you're demonstrating you know very little about the industry you're pontificating about!

So do tell how we're going to control health care costs when we pay everyone involved far more than any other nation.

Eventually, as government is forced to pay for an ever-increasing percentage of health care costs, they will dictate what they will pay. At this point hopsitals will have to make a choice - go out of business or reduce costs. The blank check days are coming to an end. Think Medicare payment schedules for everything.

 

[TragicMonkey]

So do tell how we're going to control health care costs when we pay everyone involved far more than any other nation.

Eventually, as government is forced to pay for an ever-increasing percentage of health care costs, they will dictate what they will pay. At this point hopsitals will have to make a choice - go out of business or reduce costs. The blank check days are coming to an end. Think Medicare payment schedules for everything.

"Everyone" isn't being paid "far more than every other nation". Until you grasp the fact that a scheduler earning nine bucks an hour isn't the same as an oncologist earning ninety thousand a month, your suggestion that the cost of healthcare is "everybody's" pay is ridiculous. It's like saying that the junior camera man makes too much money because Brad Pitt gets twenty million per film.