Printable View
[QUOTE=Jackson]Medical malpractice lawsuits and medical malpractice insurance premiums, in part.
It's interesting how The Messiah's health reform doesn't even address tort reform. Could that be because the vast majority of litigation lawyers are Democrats?
Thanks,
Jackson[/QUOTE]Jackson,
He did addess it. He said he is against award limits. I remember him saying this in front of a physicians group which was followed by a loud groan from the audience.
Change you can believe in!
[QUOTE=Jackson]Medical malpractice lawsuits and medical malpractice insurance premiums, in part.
It's interesting how The Messiah's health reform doesn't even address tort reform. Could that be because the vast majority of litigation lawyers are Democrats?
Thanks,
Jackson[/QUOTE]Hi Jackson,
I agree the need for tort reform is part of the problem and it’s a good place to start. However I’m not convinced it’s the whole problem.
For example I currently have prescription drug coverage with staggered co-pays, depending on the drug. I have found that I can buy these drugs in Argentina or the Philippines for about the same over the counter price as my co-payment here, depending on the exchange rate on any given day.
Now in Argentina they produce drugs so you could possible explain it away, but in the Philippines the drugs are imported and I’m buying the exact same brands and the over the counter cost is roughly the same as my co-payment. How is that possible?
I think we should consider reducing the prescription requirement for many drugs, why should I have to see a Doctor and get a prescription to buy antibiotics, vitamin V, and a lot of other drugs? I’ve heard all the arguments for this, but I see it as just another unnecessary costly regulation. Look at what you can walk in and buy in BA.
My plan for retirement is to carry the cheapest coverage as I can, which is a high deductible major medical plan, and I may dump that at some point considering I will be out of the USA most of the time. My worst nightmare would be to have a major problem while in the USA.
I tend to agree with El Queso, we do abuse the health system, and insurance companies abuse us, but as for the currently proposed legislation,
Well I vote [b] “Present” [/b]!
Everyone is ignoring the BIG benefit to a health insurance plan, besides the catastrophic coverage. The plans get a big discount from the doctors and hospitals. Even if you pay the entire bill yourself, the discount often saves thousands of dollars. Hospitals justify charging uninsured patients a huge markup as a means to pay for those on a plan or just plain destitute. This to me is patently unfair and a justification for some kind of national health insurance. I don't understand why this topic gets no coverage in the press.
1. The advertised rates are not binding and the carrier does not have to offer you any insurance at all--this is for individual policies and a simular set of rules that are more liberal apply to groups of less than 50. The check your medicaL HISTORY BASED UPON THE MEDICAL INDEX BUREAU--another sesspool of misinformation and coruption which is not regulated.
2. In Florida, there are no longer run of the mill medical malpratice claims--they have been legislated out of existance for some time. The only malpractice claims left are catastrophic and clear -cut negligence that runs outside of known risks and the attorney is personally libel for the costs and atty fees otherwise. At one point I did malpratice defence as a substantial part of making my living. Malpratice is dead in florida with very limited exceptions.
-the rate setting in Florida for malpracice insuranace has very little to do with the claims paid, the way it is in most states. Florida is controlled by large corpations.
There are almost no consumer rights groups that have any say and organized labor has been lesgistlated out of existance.
3. Healthcare is broken here because it is 100% controlled by huge unregulated oligopolies---simular to the unregulated boys who brought you the mortgage industry w / o regulation. The only other group who has any real say is the AMA--medical doctor's lobbying group--which is highly political--one specialty gets rich and other has it's income cut in half.
Eg I needed an epidural block last year. It is a procedure that takes less than 5 minutes, but must be done under a floriscope. I wait for my block --ten men where lined up in the doctors's office. He did 10 at maybe an average of 5 minutes each. My insurance paid him US$875 for this 5 minute procedure.
-the primary care doctor sent me for some physical therapy--6 sessions and my problem was 80% cured. The primarly care doc and my neurologist both told me not be get another block--the blocks offer not permanent benefit and they are designed to stop inflamation enough to start other types of treatment.
On my return visit to the doc who gave me the block, the doc told me that I needed a series of nine or I could end up paralyzed. I got up and walked out the door and never went back. This doc was motivated by greed, not good medical practice. I called my cousin who is the same specialty as the doc giving the block--my cousin said blocks are a cash cow and I did not need another block and in fact recomended an acupuncturist.
My cousin is a medical school professor and not a businessman. Since seeing the acupuncturist have have not need any medication nor additional medical care. A broken sick system wherein each player with power is grabbing for $$$ like greedy pigs. The invisible had of the market needs help of some sort.
[QUOTE=BA Luvr]Everyone is ignoring the BIG benefit to a health insurance plan, besides the catastrophic coverage. The plans get a big discount from the doctors and hospitals. Even if you pay the entire bill yourself, the discount often saves thousands of dollars. Hospitals justify charging uninsured patients a huge markup as a means to pay for those on a plan or just plain destitute. This to me is patently unfair and a justification for some kind of national health insurance. I don't understand why this topic gets no coverage in the press.[/QUOTE]Reminds of a woman telling me how much she saved because she bought everything on sale. Of course, she didn't really need those things.
What I do not understand in all of the debate concerning healthcare / insurance is politicians are able to find the bucks to fund a trumped up war in Iraq and yet cry like hell when they are asked to fund / reform a broken health care system. It just seems our priorities are all screwed up. The whole bunch of them (Democrats / Republicans) are a disgrace.
It is pretty simple, really.
You get what you pay for and you are also paying for someone else.
To understand the US healthcare system and its pluses and minuses you need to throw out your preconceived notions about it and the misinformation that you have been fed by the media and the left for the last 50 years. You need to understand a few simple facts about the current state of the industry and some basic business principles (this is an apolitical overview)
First, the facts:
1. The quality of health care (the care itself, not the system) available in the USA is the best in the world,
2. Much (not all) medical and pharma innovation occurs in the US and by US companies,
3. It is available to all (yes all) and if you can't pay for it, it's "free" (just walk into any emergency room and see for yourself)
4. Government intervention and interference in: a) the delivery of services, b) the third-party payer system / insurance industry, and c) the macro-level machinations of the marketplace, drives up the cost of services and products,
5. Our ever increasingly litigious society, characterized by bums like John Edwards making tens of millions by suing doctors and winning based on junk science, puts an enormous burden (read 'cost') on care providers (malpractice insurance, legal fees, etc) pharma and device companies (product liability, legal fees, etc)
6. Only about 35% of the 'customers' are paying full freight, therefore they must help to underwrite the care of th3 65% who do not.
7. The cost of the drugs is higher in the US than many places around the world.
Now business 101:
In order to have a sustainable business in a free market (and I am still using that term loosely for some US markets) one needs to collect more money than one expends, during the course of business. That means that in the case of a provider of services, it needs to be able to sell those services for an amount that exceeds all of the direct and indirect costs, related to the delivery of the specific service.
Direct costs are pretty straight forward they include the drugs, artificial hips, titanium pins, prosthetic peckers and saline D-cups as well as the time of the staff when they are actually working on the patient case.
The indirect costs are where it gets confusing. The indirect costs are innumerable, but include things like: a) overhead (admin staff, rent, utilities, maintenance, garbage collection, computer networks, software licenses, etc) be) medical equipment (monitors, surgical tools, IV pumps, lights, incubators, MRI machines, etc) c) regulatory compliance (all costs for compliance with things like JCAHO, OSHA and the Americans with Disabilities Act ("ADA") which often include additional staff just to administer compliance) d) many different types of insurance (covering the facilities, the caregivers, the employees, the patients, the equipment, the directors and officers of the corporation, etc) and e) many different taxes (on services, products, profits, etc)
Oh yea, I left out one particular little indirect cost, that is the cost of paying for all of the people who pay nothing or who pay an amount less than the actual cost of the delivery of services (this includes all Medicare and Medicaid transactions)
Hospitals have to make money to stay in business. When 65% of the customers do not cover the cost of services, the other 35% and benefactors (I. E. The government, err. I mean the tax payer) have to make up the difference.
The drug companies need to make a profit and earn back the R & D dollars sunk into developing, producing and selling the drug. Otherwise, they can't keep the lights on and pay the smart people who come up with this stuff. They also pay more for regulatory compliance and insurance in the USA. Further, many countries do not let them charge market rates or do not protect their intellectual property, so they cannot charge prices that enable them to make enough profits to generate the returns that they need.
Both providers and product makers have every right to sell the products and / or services drug for a price that the market will bear and make a profit (IT'S CALLED FREEDOM!
OK, we are on a roll now, so let's look at an example. Let's say that an unlucky monger goes to Checker's Pub and a few days later, back in the states find some sort of gangrenous infection in / on his pecker. He winds up in the hospital and gets a series of treatments for hi maladies.
While in the hospital, he is a) tended to by a staff of doctors, nurses, orderlies and administrators (all of whom need to get paid for working at the hospital, otherwise, they would have to do something else or starve) b) comfortable in a nice room, c) fed and watered, d) administered drugs, e) subject to many tests (probably more than necessary, but healthcare providers must over-test to mitigate legal liability. Hopefully, his infection goes away and the medical staff is able to save his pecker to monger another day. In order for the hospital to be a sustainable business (that means make a profit and keep the lights on and doors open) they need to collect revenue from someone that exceeds the direct costs incurred while delivering services to that patient and the associated indirect costs allocated to that patient. Depending upon 'who' is paying, the answer will vary. Let's look at how the current system pays:
1. If the monger walked in the emergency room and declared that he was destitute or an illegal alien, his care is "free." Err, by free, I mean that the person receiving the care pays nothing—but here's the little secret – SOMEBODY ELSE HAS TO PAY FOR IT.
2. If the monger is covered by Medicaid or Medi-care, the government 'reimburses' the hospital a set amount for the treatment. This amount has historically averaged 35% of the costs of treatment (the actual costs, not the billable revenue that a paying customer would be charged) That is right, the hospital just lost 65% of the costs incurred while caring for that patient. So if the hospital lost that money, how are they going to stay in business? SOMEBODY ELSE HAS TO PAY FOR IT.
3. If the monger has medical insurance, he pays the deductable or co-pay and the insurance company pays the hospital a pre-arranged amount for the services rendered. Depending upon the specific procedure and the health care plan, the hospital may break even or maybe they might make one of those evil profit thingamagiggies (but not the type of profit margin that can sustain all of the non-payers and other costs that the hospital must absorb over the course of a year) Where does that money come from? SOMEBODY ELSE HAS TO PAY FOR IT.
4. If the monger has the money and pays out of pocket when in need of medical care, he will receive a bill for the services render which will include the direct costs, the indirect costs and a profit margin that is mostly dictated by market forces. He can then look in the mirror, admire his health Johnson and see one of the people who is paying for all the other people and all of the 'extra' burdens the health care industry is under.
You, the out-of-pocket payers and the tax payers are the 'somebody else.' Under the proposed Obama-care, everyone (except Congress) will be forced into category #1. Someone please tell me how that will sustain itself?
[QUOTE=Damman]What I do not understand in all of the debate concerning healthcare / insurance is politicians are able to find the bucks to fund a trumped up war in Iraq and yet cry like hell when they are asked to fund / reform a broken health care system. It just seems our priorities are all screwed up. The whole bunch of them (Democrats / Republicans) are a disgrace.[/QUOTE]Hi Damman,
With all due respect, the Democrat's stimulus plan (AKA "The State and Local Government Employee Job Security Act") cost more than the Afghanistan invasion, the liberation of Iraq, and the Hurricane Katrina cleanup combined.
The various proposed health care bills all will cost five times as much in the first 10 years than the total cost of the liberation of Iraq alone.
Do you think that the cost of the liberation of Iraq is the important issue now?
Thanks,
Jackson
[QUOTE=Jackson]Do you think that the cost of the liberation of Iraq is the important issue now?[/QUOTE]Jax:
You hit the nail on the head. I haven't heard anyone, particularly any of the drones on the left, complaining about the cost of the war in Iraq, since. January. I wasn't paying attention back then, did something happen that made the war more affordable? Is there some other explaination?
I'm lost on this one.
Jackson.
According to the LA Times (4/11/09) Iraq war cost about $694 billion and still counting. It will pale in comparison to any health plan when it is all said and done: veteran benefits and such over the next 50 years. These things do not end in some BS ceremony. For health care, a conservative estimate is $1 trillion over ten years: BBC. The numbers are mind boggling either way. The Iraq War is a tragedy and should never of happened. Of course, Iraq is my personal view and perhaps that is where we disagree. Guess my whole point is that we can always find the bucks to fight and perpetuate these trumped up wars, but never a buck for something domestic. For myself, our priorities are skewed. Iraq over health care, a no brainer in my view. Anyway, the whole issue is moot, the country is overextended and the money is spent. We are F....d.
And please, do not get me going on Katrina. A National embarrassment by the brain trust in Washington.
[QUOTE=Jackson]Hi Damman,
With all due respect, the Democrat's stimulus plan (AKA "The State and Local Government Employee Job Security Act") cost more than the Afghanistan invasion, the liberation of Iraq, and the Hurricane Katrina cleanup combined.
The various proposed health care bills all will cost five times as much in the first 10 years than the total cost of the liberation of Iraq alone.
Do you think that the cost of the liberation of Iraq is the important issue now?
Thanks,
Jackson[/QUOTE]
This health care abomination is not just costly in terms of dollars (it will bankrupt the country) There is a cost that is priceless and that it our freedom. The House bill makes private insurance illegal for anyone who changes any part of their plan, after the grace period is over. You have no choice regarding your coverage. You will not have choice regarding your care.
If you think that they will stop at taking your health care choices away from you, you are wrong. You will not be able to chose the car you drive. You will not be able to chose to smoke. You will not be able to chose to run our business free of government interference. You will not be free.
For the party that claims to be for choice, I'm stumped at why they want to take all of our choices away from us and make them for us.
The costs and benefits of the Iraq war cannot be measured in dollars either. It was the right thing to do. We did it because we alone had the ability and fortitude to do it. We are losing on every international front under Obama. He is a child when it comes to international issues. Unfortunately, he is a full grown Marxist on internal affairs. Yes I said Marxist, I mean it, it is not hyperbole. I have a copy of Das Capital on my desk (the same one I read for the first time 25 years ago) and will bring it to Newport next time and let any of you read it for yourselves.
Insurance is not subject to price fixing regulation and anti-trust. When we were childern, the insurance industry lobbyists sold us a bill of goods that the dr's were making too much money---so we need managed care to control the evil doctors and hospitals. Now we are controlled by Huge powerful Health Carriers--w / near unlimited lobbying $$$ and the resultant political power.
Why do I buy my prescription drugs in BA instead of the USA? At 7% of the cost in the USA manufactured by the brazialian branches of the same companies that market indentical drugs for 15x's more in the USA. Is there a middle ground? I would know that there must be one.
What drug industry exerts it's influence so that the bushies make it illegal for medicare to even attempt to negotiate a bulk discount--this is not free market capitalism. There is no free market. You are an intelligent man and you are repeating the drug industry's corporate PR. Which is another incidental cost like the administration of huge managed care companies; drug companies and their lobbyists.
I truly believe that this is a broken system and that we have all been hoodwinked. What goes along with this is that the USA has the most expensive health care in the world by far and we are number 37 by other standards. Yes, we may have to make hard discissions about what we spend money on in the health care arena. How long does a brain dead human being with no chance of having a functioning brain spend in the ICU? God I don't know the answer, but delegating these choices to executives at a managed care organization not the answer.
The brits I know--not too many--like their national health care system and the people I know with money also have a secondary insurance to by pass the state or pay out of pocket if they don't want to wait.
WE don't have free market capitalism in health care in the usa--it might be offensive to your basic world view---but take a look at the movie sicko--yes sicko is loaded with over statement, but there is some truth there.
WAlley, please rent sicko and watch it. Forget your business education and work for a second and think from a policy perspective. We are #1 in spending and # 37 in quailty of care. Something is wrong
We can certainly agree to disagree.
However, there are only two classes of Brits, that I have come across, that like the nationalized health system 1) those that are healthy and don't need it and 2) those who profit financially from that behemoth. The secondary system to which you allude is called CASH. When you call for an appointment, the receptionist will ask if you are a Public or Private patient. If you say Private, come on in. If you say Public, we'll see you in a month.
Rather than looking at some ranking that places our health care at #1 or #37 (which I doubt) answer me this, how many people leave the US to seek care vs. Those that come here for care?
The problems in health care started long before the Bushies got to DC.
Michael Moore is a whole other story. I would not knowingly put a dime in his pocket (or piss on him if he were on fire) There are plenty of credible sources for information, he is not one of them.
There is a difference between health insurance and a health plan. When we were kids, most people paid out of pocket for regular medical expenses and carried major medical insurance coverage for big, unexpected stuff. I think we should go back to those days. With free market solutions, there would be choices for those who wanted coverage for visits, etc and they would be appropriately priced. Today, everyone thinks that doctor visits should be $20 and drugs should be $5-15 dollars (health plan)
Think about your car. You carry insurance for accidents and you pay out of pocket for oil changes, tune ups, gas and wiper blades (unless maintenance is included in your deal with the car company - not the insurance company)
As for having difficulty finding a plan (as you mentioned earlier) I had a similar experience a year or so ago. At first, no plan seemed available with preexisting conditions (nothing serious) Finally, I found one that was much cheaper ($800/ mo) than what I was paying ($1800/ mo or so) that gave me all of the coverage I wanted but with higher out of pocket costs. That's fine with me. I keep $12k in my pocket. If I spend more out of pocket for doctor visits and drugs, I am still not going to spend $12K in the course of a year.
You have probably already tried healthplanone. Com if not, give it a try. Also, as you mentioned previously, it is easier to get a specific individual covered through a group (benefit companies look to bury the couple of un-insurable people within a group to slide it by the underwriter)
There is also a big reason that the government wants to destroy private health insurance, money. Think about the cash reserves that the private insurance industry has to keep in order to underpin their policies. Where do you think that money is going to go? What do you think the government will do with it? Put it in a "Lock Box?" I doubt it. They will squander it (think medi-care, medicaid and social security) If you thin Madoff was bad (I do) he only stole $50B in one ponzi scheme. The government will steal many times that through these three ponzi schemes.