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

[TragicMonkey]

It just occurred to me that the pay in fast food is way too high. The CEO of McDonalds makes millions! Let's cut the pay of Judy the girl who refills the grease in the fryer. That rich bitch!

 

[WildCat]

"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.

That it's not evenly distributed does nothing to disprove the argument that US health care workers make far more than their foreign counterparts.

It just occurred to me that the pay in fast food is way too high. The CEO of McDonalds makes millions! Let's cut the pay of Judy the girl who refills the grease in the fryer. That rich bitch!

I'll worry about that when the government has to pick up the tab for fast food meals to prevent deaths from starvation. Nobody has to buy a Big Mac, if you go without health care you will die.

 

[TragicMonkey]

That it's not evenly distributed does nothing to disprove the argument that US health care workers make far more than their foreign counterparts.


I'll worry about that when the government has to pick up the tab for fast food meals to prevent deaths from starvation. Nobody has to buy a Big Mac, if you go without health care you will die.

I see. So you advocate reducing the pay of everybody in an industry, no matter what their pay is, because collectively they make more than the collective pay of that industry in another country. So the minimum wagers get their salaries slashed just as much as the top earners, executive directors are treated the same as janitors, and I'm the same as the chief brain surgeon.

Okay then, should we all make the same salary? Or do you just want to reduce our current salaries? By a percentage or a flat amount? If it winds yup being negative should we just work for free, or should we work and pay the difference also?

 

[WildCat]

I see. So you advocate reducing the pay of everybody in an industry, no matter what their pay is, because collectively they make more than the collective pay of that industry in another country. So the minimum wagers get their salaries slashed just as much as the top earners, executive directors are treated the same as janitors, and I'm the same as the chief brain surgeon.

Okay then, should we all make the same salary? Or do you just want to reduce our current salaries? By a percentage or a flat amount? If it winds yup being negative should we just work for free, or should we work and pay the difference also?

I advocate nothing except the US government using all of their influence to control health care costs. Basically they pay a given amount for a given procedure, it's up to the hospitals to figure out where they can cut costs. Maybe they cut your pay, maybe not. But we obviously can't keep on paying such ridiculous and extraordinary sums of money for health care. Something's got to give.

 

[uk_dave]

I suspect that one reason why the costs are over inflated is that so much health care is unfunded in the US.

On other threads it's been almost presented as a virtue that even without insurance a US citizen can still get treated at the local A&E

Now, they may well get a bill for this treatment and the size of that bill may well push them into bankruptcy, but the chances are they won't actually pay for the treatment.

Well, someone has to pay, right? So all those costs probably get pushed on to the insurance companies, which in turn make the insurers leery about runaway costs so they introduce caps and co-pays and pitch it at a level where the consumer is going to hurt but will probably pay.

Far better would be to spread that cost over all tax payers. Then the medical centres can stop inflating prices and instead charge appropriately knowing that the costs will be met.

 

[TragicMonkey]

I advocate nothing except the US government using all of their influence to control health care costs. Basically they pay a given amount for a given procedure, it's up to the hospitals to figure out where they can cut costs. Maybe they cut your pay, maybe not. But we obviously can't keep on paying such ridiculous and extraordinary sums of money for health care. Something's got to give.

So you have backed off from your claim that its the pay of "everyone" in the healthcare industry that's responsible for the high costs.

 

[TragicMonkey]

Far better would be to spread that cost over all tax payers. Then the medical centres can stop inflating prices and instead charge appropriately knowing that the costs will be met.

Exactly. There's a lot of waste created by the need to fight for payment. If we knew for sure that X would always pay Y for Z, without needing to file and refile and negotiate and edit and reclaim and even litigate, then a lot of costs would be eliminated.

Hell, just knowing in advance what the likely income and costs were going to be would be a huge advantage. Imagine if your salary were different every week, and you had to manage your budget.

 

[CORed]

Exactly. There's a lot of waste created by the need to fight for payment. If we knew for sure that X would always pay Y for Z, without needing to file and refile and negotiate and edit and reclaim and even litigate, then a lot of costs would be eliminated.

Hell, just knowing in advance what the likely income and costs were going to be would be a huge advantage. Imagine if your salary were different every week, and you had to manage your budget.

Exactly. Many of the insurance companies are quite aggressive in negotiating payment. Add to that that many uninsured people get treated in emergency rooms and don't pay their bills, and the doctors and hospitals make that up by soaking the uninsured or under-insured who do find a way to pay their bills. Not to say that plain old greed isn't also a factor.

 

[Nessie]

Exactly. Many of the insurance companies are quite aggressive in negotiating payment. Add to that that many uninsured people get treated in emergency rooms and don't pay their bills, and the doctors and hospitals make that up by soaking the uninsured or under-insured who do find a way to pay their bills. Not to say that plain old greed isn't also a factor.

How does it work with the uninsured. The article referred to treatments being delayed until money was paid up front.

 

[TragicMonkey]

How does it work with the uninsured. The article referred to treatments being delayed until money was paid up front.

Emergency treatment cannot be delayed for payment reasons, its a law. Non emergency treatment policy varies by provider. The two I've worked for treat first, worry about the money later, even if it means eating the loss. But they can afford to do that, not all providers can.

Contrary to political slant, not all of American healthcare is run by greedy bloodsuckers. We're not the RIAA.

 

[monty1]

You seriously have no freaking clue. Stop smoking xenophobic weed and take an honest look at the rest of the 1st world countries.

Once you stop listening to right wing talk radio and take an honest and fact based view (you can't do the latter without doing the former), you'll realize that the health care in the U.S. sucks.

The "fact" you state is simply not supported by real facts and real studies.

Well said David! This has been picked up by Americans and they're carrying the ball on this issue, at least on this forum. I'll leave it to those who know more about the subject and care.

 

[uk_dave]

Emergency treatment cannot be delayed for payment reasons, its a law. Non emergency treatment policy varies by provider. The two I've worked for treat first, worry about the money later, even if it means eating the loss. But they can afford to do that, not all providers can.

Contrary to political slant, not all of American healthcare is run by greedy bloodsuckers. We're not the RIAA.

I thought we were in agreement that those losses are precisely the reason why charges for health care are so high when passed on to paying individuals and insurers.

Of course the providers don't worry about the loss, they can charge silly amounts for an aspirin.

 

[Sabretooth]

I'm curious as to how the ACA is going to help. I heard both sides of the argument, but I can't see how taxes won't have to increase significantly to pay for it.

Also, I'd like to see an average breakdown of payroll taxes and sales taxes that UK and Canada see to cover the costs of UHC.

 

[TragicMonkey]

I thought we were in agreement that those losses are precisely the reason why charges for health care are so high when passed on to paying individuals and insurers.

Of course the providers don't worry about the loss, they can charge silly amounts for an aspirin.

Not all losses are passed on.

 

[monty1]

I'm curious as to how the ACA is going to help. I heard both sides of the argument, but I can't see how taxes won't have to increase significantly to pay for it.

Also, I'd like to see an average breakdown of payroll taxes and sales taxes that UK and Canada see to cover the costs of UHC.

Just have a look at Canada's health care system which is funded for half the cost of yours and is of a higher quality according to the WHO.

All you want to look for is negativity and answers that will strengthen your argument against the ACA. All you really have to know is that we pay less in taxes overall than you do.

But go ahead, discredit the WHO and everything else positive and screech about the negatives of giving your people affordable health care.

Thankfully I don't have to drive it in with a sledge hammer, the majority of Americans have picked up the ball now.

 

[lobosrul]

I'm curious as to how the ACA is going to help. I heard both sides of the argument, but I can't see how taxes won't have to increase significantly to pay for it.

Also, I'd like to see an average breakdown of payroll taxes and sales taxes that UK and Canada see to cover the costs of UHC.

Maybe that's what your looking for:

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

We pay roughly double what other 1st world countries pay per capita for healthcare. And they almost all live longer.

At the end of the day, does it really matter if its a tax, or out of pocket?

 

[jimbob]

Maybe that's what your looking for:

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita

We pay roughly double what other 1st world countries pay per capita for healthcare. And they almost all live longer.

At the end of the day, does it really matter if its a tax, or out of pocket?

And you pay roughly what I pay in tax for healthcare (slightly more in 2007) whilst I pay nothing for private medical insurance.

 

[lobosrul]

And you pay roughly what I pay in tax for healthcare (slightly more in 2007) whilst I pay nothing for private medical insurance.

23% of the United States TOTAL federal budget was spent on medicare/medicaid, more than the DoD! Roughly $2600 per capita, when it only covers a small minority of people. Even worse, only a little over half of all medicaid expenditures are paid at the federal level. So in reality it costs even more. WHAT THE ----?!

 

[TragicMonkey]

23% of the United States TOTAL federal budget was spent on medicare/medicaid, more than the DoD! Roughly $2600 per capita, when it only covers a small minority of people. Even worse, only a little over half of all medicaid expenditures are paid at the federal level. So in reality it costs even more. WHAT THE ----?!

We only have government paid healthcare for the elderly- the absolutely most expensive demographic. Its also not restricted by means- Joe Blow the retired farmer and Jill Crow the retired Proctor and Gamble heiress both get Medicare coverage.

 

[jimbob]

23% of the United States TOTAL federal budget was spent on medicare/medicaid, more than the DoD! Roughly $2600 per capita, when it only covers a small minority of people. Even worse, only a little over half of all medicaid expenditures are paid at the federal level. So in reality it costs even more. WHAT THE ----?!

Indeed - I would be slightly miffed if my taxes went to providing health coverage for people wealthier than me, if they didn't provide for my family and I had to shell out for inadequate cover on top of that.