I guess, but GD have you ever seen an itemized bill on a hospital stay? Some of that **** is highway robbery. Any rational, sane person knows OTC pills don't cost hundreds of dollars, especially at a place where they get them wholesale.
Universal Healthcare
- Thread starter Chuckinden
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I guess, but GD have you ever seen an itemized bill on a hospital stay? Some of that **** is highway robbery. Any rational, sane person knows OTC pills don't cost hundreds of dollars, especially at a place where they get them wholesale.
On the flipside, extra profit via cutting corners at every level of corporate America is a big thing now, so I don't think there's much motivation to "improve" anything but the bottom line. It's usually finding the perfect balance of how to get the most work out of the fewest amount of people you can, which sometimes results in overworked staff doing half-assed jobs.
I'm fine with for-profit care to a point, but I'd rather the emphasis be placed on care rather than profit.
I wonder if that $8 Bandaid I bought in a hospital about 15 years ago has gone up in price. No insurance. Took me years to pay that one-night hospital visit off. It would cost ten or twenty times more at today's rates. It probably saved my wife's life though (internal bleeding) so there is that.
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A few points.
There is no such thing as a perfect health care system. Every system has strenghts and weaknesses. So to discount any program based on one or a group of negatives is short sided. The goal should be to cover as many as possible, in as efficient a manner as possible and at the lowest cost we can.
We actually have historically had a version of universal health care system. However it consists of insurance for those whose employers offer it, can afford to pay for it on their own, or who are impoverished and fall within the Medicaid guidelines Those without insurance must largely receive health care at hospital ERs. However being unable to pay for those services in many cases results in the cost falling back on the insured and the tax payer only at a much higher cost then preventive care would have cost in the first place. This and other reasons are why health care cost per ca pita in the US is the highest in the world.
Just about ever other industrialized country in the world has come to the conclusion that the best way to address healthcare as I stated above is for some sort of single payer system, most under the auspice of the government. For those that argue against a government based health care system on the ground that it would be less efficient, I would propose the following. Allow Medicare to compete head to head against private insurers and let citizens choose which they prefer. If the government is as inefficient as it's critics claim, then the market forces will lead people to buy from private insurers, if OTOH the government can provide a better system of administering health care claims at rates that are competitive or lower than private insurers, then the citizens benefit from a better system.
I just find it hard to believe that the United States government cannot achieve what the government of Australia has achieved which President Trump himself recently acknowledged had a better system then we have. I don't think our government is inferior to everyone else.
On the issue of medical costs, which largely drive the cost of insurance, several good points have been mention by other members above. I agree that allowing competition for drug prices, and utilizing neighborhood walk in clinics like CVS's minute clinic are a few of many ways we can lower costs. Also insurers be they private or government, should be allowed to incentivise healthy live styles by offering lower rates to those that stay in shape.
There is no such thing as a perfect health care system. Every system has strenghts and weaknesses. So to discount any program based on one or a group of negatives is short sided. The goal should be to cover as many as possible, in as efficient a manner as possible and at the lowest cost we can.
We actually have historically had a version of universal health care system. However it consists of insurance for those whose employers offer it, can afford to pay for it on their own, or who are impoverished and fall within the Medicaid guidelines Those without insurance must largely receive health care at hospital ERs. However being unable to pay for those services in many cases results in the cost falling back on the insured and the tax payer only at a much higher cost then preventive care would have cost in the first place. This and other reasons are why health care cost per ca pita in the US is the highest in the world.
Just about ever other industrialized country in the world has come to the conclusion that the best way to address healthcare as I stated above is for some sort of single payer system, most under the auspice of the government. For those that argue against a government based health care system on the ground that it would be less efficient, I would propose the following. Allow Medicare to compete head to head against private insurers and let citizens choose which they prefer. If the government is as inefficient as it's critics claim, then the market forces will lead people to buy from private insurers, if OTOH the government can provide a better system of administering health care claims at rates that are competitive or lower than private insurers, then the citizens benefit from a better system.
I just find it hard to believe that the United States government cannot achieve what the government of Australia has achieved which President Trump himself recently acknowledged had a better system then we have. I don't think our government is inferior to everyone else.
On the issue of medical costs, which largely drive the cost of insurance, several good points have been mention by other members above. I agree that allowing competition for drug prices, and utilizing neighborhood walk in clinics like CVS's minute clinic are a few of many ways we can lower costs. Also insurers be they private or government, should be allowed to incentivise healthy live styles by offering lower rates to those that stay in shape.
trump clearly doesn't understand what we have. we have the best health care system in the world. bar none.
it's just not universally accessible (which we should fix). go talk to canadians who live in canada and need surgery. they will tell you how frustrated they are with government health care.
so you mean you wonder why the U.S. can't achieve what the Aussies have by insuring their 23 million person population vs our 300 million plus? it is laughable when you libs try to compare the countries with national healthcare to our system when you are talking about countries with populations less than that of many states in our country. insuring 20 to 30 million with relatively no defense budget compared to insuring 300 million plus while having to be the defender of freedom all over the world doesn't compare in terms of cost and scale
The problem is you're asking the wrong question....and asking the wrong people. The question you should ask your Dr is, "do I need this test?" Most medical providers, like myself, don't know the costs.....at least to a large degree. The cost is determined by the billing department and the insurance company. If you want to know the costs of things you have to talk to them. And, of course, most people don't.
But that depends on what criteria you use to judge it. If you judge it based on the quality of care I would agree with you, but if you judge it based on the number of citizens that are covered and on the per capita cost, we fall far short of countries like France or Canada.
Actually we spend our winters in Florida and have several Canadian neighbors and friends down there and they would not dream of trading their health care system for ours. In fact when the topic comes up, they usually seem quite puzzled and ask why we don't have a comprehensive system like everyone else has.
Great point and I totally agree with you, but I don't see how the size of the number of insured effects per capita cost. This is where we fall short. Again all I'm suggesting is we allow competition between Medicare and private insurance and give citizens the choice. I don't really see anything "liberal" about that, in fact it's Republicans that are strongly advocating increased competition for plans and I totally agree with them on that.
Literally everyone should click on the link to the podcast that I provided on the first page.
I don't want to pay anymore, even though I already am. I want everyone to be responsible for their own care and coverage.
The unsatisfied customer can take their business elsewhere, and the overworked employee can go work for a competitor. When those two things occur, the offending corporation corrects its mistakes or they fail. It happens everyday in every other industry.
Me too.
And that is currently a fantasy, in part because insurance is tied to employment.
I've been self-employed for 3 years now. I have never, ever missed a premium payment nor have I ever failed to timely pay a medical bill.
However, every year my insurance has been cancelled by each provider because they state that they no longer will insure a self-employed person in Kentucky.
This happened repeatedly even though I carried high deductible - HSA plans and basically self-insured for everything except unforeseeable calamity like a car wreck, cancer, etc.
I'm reasonably healthy 35 year old man who is slim, has good blood work, etc.
I have no open market to go to in order to price an appropriate plan for me (and maybe my wife). Nor do I have the ability to negotiate rates for specific services prior to taking those services, so the high deductible gets eaten up quick and without my ability to influence it.
The only reasonable option is to obtain health insurance through my wife's employment, despite that facts that we both earn an income high enough that we can support a more tailored plan, that I have proven my credit worthiness and healthiness as an insurance client, and frankly I can pay for ****.
It is an absurd system at current, especially if you are self-employed.
The ACA was designed to fail. They knew once you give an entitlement, it is impossible to take it away, therefore the only thing left is single payer.
My titanium shafts on my golf clubs cost $80 a pop. Where did the other $999,920 go?
It's a problem to be as less biased as possible when trying to act on behalf of the patient?
Besides the reason why many of us don't know is because there are different expenses for the consumer. Let's say a company chargers $2000 for a test. If 100 patients have different insurance policies they may all pay different amounts. And the company may get reimbursed 100 different amounts.
You should see what's in the surgeon's bag?
Single payer was the plan all along. Will patient care improve? Not one bit. Will availability of prescription meds improve? Not one bit. You know what will improve? Jobs for bureaucrats. And you can bet your behind that rationing WILL take place. Just look at the VA. A good friend of mine is a disabled vet, and has Type 2 diabetes, just like I do. Works out like a fiend, doesn't drink nor smoke. I CAN say that I don't smoke. And he has to take the blue pill just to have relations with his wife. Guess how many blue pills he gets a month from the VA? FOUR. So for you fans of single payer, your medical care will get rationed and controlled by some faceless, nameless cog in the machine. And you will get exactly what you deserve.
I recently listened to a Dan Carlin broadcast that addressed health care that I would highly recommend. It talks about the fact that we are currently paying more for healthcare than any other country in the world, and we are certainly not getting our moneys worth. For those who want a good picture of many of the problems we face on this issue, it is worth a listen.
Morgan Spurlock had an interesting episode of medical tourism, being cheaper to fly outside of the US for healthcare.
The US has the best healthcare, if you can afford it. Seen providers to the same tests multiply times, you would think they all could use the same test results than getting their share.
The US has the best healthcare, if you can afford it. Seen providers to the same tests multiply times, you would think they all could use the same test results than getting their share.
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We should stop tinkering with health care until we build cost cutting measures into the fix. Any system that starts out with me having to fill out the exact same information every time on paper has no chance. Health history has to be shared between provides on a secure system. Any system that requires duplicate testing to avoid malpractice but not to improve patient care has no chance. Any system that spends such a large percentage of its resources keeping people alive at the end of life with no improvement in quality of life has no chance......
People will still work for salaries.
The universal model works in every industrialized nation in the world. Why would you think it wouldn't work here.
This is the attitude I find frustrating from people in this country anymore. Think about how absurd it is for the federal government to become a competitor against private enterprise. This is not socialism. Would it be okay if the federal government started building cars, ovens, refrigerators, washer and dryers, baking bread, etc., and competing against private companies? The very idea runs so counter to how our government works that it is unbelievable that some people think this is just fine and dandy. It just demonstrates how our education system has failed its citizens.
non-profit doesn't mean people don't get paid, work for free. Non-profit hospitals exist today and in fact up until the late 60's when Tom First founded HCA and started the for-profit hospital model.
The actual number of people benefiting from for-profit medicine is small in relation to the number of people that work in the industry. HCA alone has over 200,000 employees. The people that profit from the business are the stockholders.
For-profit industries will consume every dollar they can extract from the system. Healthcare is a human necessity. If your child is diagnosed with cancer are you asking how much treatment is going to cost? It is what it is. You're going to pay whatever it takes because it is the life of your child at steak. For-profit medicine knows it.
If you break your leg...what are you going to do? Make a splint out of a couple of 2x4s and try to set the bone yourself?
What incentive does the medical community have to cut prices? Ever go to the doctor and not have to wait? For essential services the system operates pretty much at capacity. The only places competition has brought down prices is with elective procedures. Breast augmentations and other elective plastic surgeries, E.D. treatments...that care that is elective in nature.
In the end it comes down to whether or not you think healthcare is a basic human right or a luxury that should only be available to those who can afford it. The rest of the world has determined that it is a basic human right. We spend 40% more per capita, have less favorable outcomes and still leave a sizable portion of our population without access to basic care.
Again, our education system has let down its citizens. Rights, as defined by our Constitution, cannot be granted by government. They are natural and exist because we exist. They were not given to us except by our creator. They are things you can do for yourself, such as free speech, ownership of property, fruits of your labor, etc. As such, you cannot have a right to another person's labor. Every person has the right to their own labor and fruits they receive from it. You do not have the right to force someone to work on your behalf, healthcare professional or otherwise. That is slavery. Healthcare cannot be a right. It may be privilege that society grants to everyone, if that is the way we head, but it cannot be a right. That is just a basic misunderstanding of what constitutes a right.
So does government not provide our police and fire protection? Provide public schools. Provide our water and sewer systems? Our power grids? Our roadways on which we drive?
Healthcare was never a for-profit industry until 1960s when employers started offering healthcare insurance for their employees. I have the hospital bill from when I was born in 1959. Mom spent a week in the hospital for a grand total of $187. My parents has no insurance, they had never had health insurance. Yes, $187 was more than $187 today but still... dad was earning $6000/yr so a week in the hospital was a little more than a week's pay. Today a normal delivery will costs between $30,000 and $50,000.
We don't have to buy cars, ovens, refrigerators, washers and dryers or even bread. None of those things are essential services.
Some random observations that kind of have a point:
1. A couple of months ago I got a letter from my health insurer, Anthem, asking "Did you know that different hospitals charge different rates for the same procedure? Shop around and find the best rates!" There are two hospitals literally a quarter of a mile from each other near where I live. For a procedure I needed, hospital A charges nearly double what hospital B charges. Anthem won't cover my procedure at hospital B. Why did they even bother to send that letter?
2. If you have a procedure, ask to pay it up front with cash without using insurance. The medical provider/hospital will charge you MORE than if you use insurance (because of their negotiated rates with insurance companies). Name any other business/industry where you pay more when paying in cash up front, and pay less when paying through a third party later on.
3. As pointed out by others, before a procedure, ask how much it will cost. They won't tell you and they probably couldn't figure it out even if they tried. The only reason I knew what hospital A and B in my point 1 above charge is that I used to go to hospital B with a different insurance, and now I go to hospital A with my current insurance. I had the same procedure done at each place and got the bills, so I know the amounts they charge. Is there any other business/industry in which they won't give you the price up front? What we have now is not capitalism.
4. Why is it two hospitals a quarter mile apart can charge such dramatically different amounts for the same procedure?
5. There are no incentives, AT ANY POINT IN THE CHAIN, for anybody in the industry to control costs (from doctors to drugs to surgical tools).
6. Far too many people go to the doctor for obvious viral illnesses like the cold or viral gastroenteritis that will go away on their own in a short amount of time and for which there is nothing a doctor can do anyway.
7. For simple things involving a visit to a nurse practitioner or primary care doctor, why is insurance even involved? These should be cash up front visits. You don't use your car insurance for an oil change or for new tires; you use it when your car gets serious damage.
8. Why are hospitals "not for profit" but insurance is "for profit?" Insurance makes a ton of money in the health care space; but unlike doctors or pharmaceutical companies or medical equipment manufacturers, they don't provide any service or do anything positive. Money should be made in medicine, but why is so much of that money made by insurance companies that add nothing to our care?
1. A couple of months ago I got a letter from my health insurer, Anthem, asking "Did you know that different hospitals charge different rates for the same procedure? Shop around and find the best rates!" There are two hospitals literally a quarter of a mile from each other near where I live. For a procedure I needed, hospital A charges nearly double what hospital B charges. Anthem won't cover my procedure at hospital B. Why did they even bother to send that letter?
2. If you have a procedure, ask to pay it up front with cash without using insurance. The medical provider/hospital will charge you MORE than if you use insurance (because of their negotiated rates with insurance companies). Name any other business/industry where you pay more when paying in cash up front, and pay less when paying through a third party later on.
3. As pointed out by others, before a procedure, ask how much it will cost. They won't tell you and they probably couldn't figure it out even if they tried. The only reason I knew what hospital A and B in my point 1 above charge is that I used to go to hospital B with a different insurance, and now I go to hospital A with my current insurance. I had the same procedure done at each place and got the bills, so I know the amounts they charge. Is there any other business/industry in which they won't give you the price up front? What we have now is not capitalism.
4. Why is it two hospitals a quarter mile apart can charge such dramatically different amounts for the same procedure?
5. There are no incentives, AT ANY POINT IN THE CHAIN, for anybody in the industry to control costs (from doctors to drugs to surgical tools).
6. Far too many people go to the doctor for obvious viral illnesses like the cold or viral gastroenteritis that will go away on their own in a short amount of time and for which there is nothing a doctor can do anyway.
7. For simple things involving a visit to a nurse practitioner or primary care doctor, why is insurance even involved? These should be cash up front visits. You don't use your car insurance for an oil change or for new tires; you use it when your car gets serious damage.
8. Why are hospitals "not for profit" but insurance is "for profit?" Insurance makes a ton of money in the health care space; but unlike doctors or pharmaceutical companies or medical equipment manufacturers, they don't provide any service or do anything positive. Money should be made in medicine, but why is so much of that money made by insurance companies that add nothing to our care?
Rights vs privilege granted to everyone is simply semantics. If you guarantee access it's a frickin' right. Have fun playing your word games. BTW, my quote was "basic human right". Nowhere did I mention the Constitution.
Nobody is forced to work on anyone's behalf. 99% of people work for someone else. If you're getting paid, if you are there on your own choosing...you're not a slave.
Not word games. There is a huge difference between the two. The fact that you don't understand the concept of a right is not my fault. It's that kind of misconception that makes people think government is the answer to everything in today's society. Government was never meant to be society's problem solver. It just shows the poor civics education that people receive in many of today's schools.
Is K-12 public education a right or a privilege? I've paid a lot of tax $$ so that other people's kids can get free public education. That education is not only allowed; it's required.
Good observations...
Medical billings is the most f#cked up industry in the world.
Billed rates and negotiated rates are apples and zebras from one insurance company to another. Wife had surgery, billed $35,000 for an out-patient procedure. The insurance negotiated rate was $9,200. For your hospital A and B... you can be sure that while one procedure is less at one, another procedure will be more. Your doctor may only practice at hospital A so if you want your doctor...it's hospital A for you.
Not all hospitals are not-for-profit. I work right next to the two largest for profit hospital chains in the country, HCA and CHS. As you can see below 6 of the largest 9 for-profit hospital systems are HQed in Nashville/Franklin/Brentwood all shoot offs from HCA which was founded by Tom Frist and made the Frist family billionaires.
For-Profit Hospital Systems
- Community Health Systems (Franklin, Tenn.)—188 s
- Hospital Corporation of America (HCA) (Franklin, Tenn.)— 166
- Tenet Healthcare (Dallas) — 74
- LifePoint Health (Brentwood, Tenn.) — 56
- Prime Healthcare Services (Ontario, Calif.) — 32
- Universal Health Services (King of Prussia, Pa.) — 28
- IASIS Healthcare (Franklin, Tenn.) — 18
- Ardent Health Services (Nashville, Tenn.) — 12
- Capella Healthcare (Franklin, Tenn.) — 9
Dude, I'll put my education and knowledge of civics up against you any day. Bring it on.
Government isn't society's problem solver but it can be a facilitator for those functions that the people see as fundamental and essential. Many people much smarter than you have come to that same conclusion. We aren't stuck in 1776 or 1789.
What's unbelievable to me is that there are people that view my health as a commodity no different than a washer or a car, that should be marked up and sold at a profit. I've taken a very broad view of this compared to some that want the government to do this exclusively - the same way defense, home land security, education, most infrastructure and other public services are done exclusively by the government. I'm offering the idea of letting private insurers continue to operate in a competitive market to see if they can justify their system, allowing people to have a choice. Notice I'm advocating choice and competition, two virtues that are strongly advocated in the Republican plan.
All I'm interested in is a system that best serves the public, at the lowest cost. That to me is more important than sticking to some abstract economic ideology.
BTW, I'm pretty proud and grateful for the educational system that served me from grade school all the way through my MBA.
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