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  1. #2821  
    Quote Originally Posted by Micael View Post
    Yes, David. My health is *my* concern, not some politician's or appointed board. I feel that it's up to me to become educated on my treatment options - as much as a layman can, and then to select a doctor that I believe I can trust to help me with the heavy lifting parts of the decision making process. If I decide along the way that he's led me down the wrong path, I can choose to engage a different doctor.
    This is how it works in the Canadian Public System....why is it that the proposed US "public" system not include such provisions? ....or rather what makes us think it will not?
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  2. #2822  
    Quote Originally Posted by ryleyinstl View Post
    This is how it works in the Canadian Public System....why is it that the proposed US "public" system not include such provisions? ....or rather what makes us think it will not?
    Here is one huge difference:

    One of the most important differences between the two countries is the much higher cost of drugs in the United States. In the U.S., $728 per capita is spent each year on drugs, while in Canada it is $509.[84] At the same time, consumption is higher in Canada, with about 12 prescriptions being filled per person each year in Canada and 10.6 in the United States.[86] The main difference is that patented drug prices in Canada average between 35% and 45% lower than in the United States, though generic prices are higher.[87] The price differential for brand-name drugs between the two countries has led Americans to purchase upward of $1 billion US in drugs per year from Canadian pharmacies.[88]
    There are several reasons for the disparity. The Canadian system takes advantage of centralized buying by the provincial governments that have more market heft and buy in bulk, lowering prices. By contrast, the U.S. has explicit laws that prohibit Medicare or Medicaid from negotiating drug prices. In addition, price negotiations by Canadian health insurers are based on evaluations of the clinical effectiveness of prescription drugs,[89] allowing the relative prices of therapeutically-similar drugs to be considered in context. The Canadian Patented Medicine Prices Review Board also has the authority to set a fair and reasonable price on patented products, either comparing it to similar drugs already on the market, or by taking the average price in seven developed nations.[90][91] Prices are also lowered through more limited patent protection in Canada. In the U.S., a drug patent may be extended five years to make up for time lost in development.[92] Some generic drugs are thus available on Canadian shelves sooner.[93]
    The pharmaceutical industry is important in both countries, though both are net importers of drugs. Both countries spend about the same amount of their GDP on pharmaceutical research, about 0.1% annually[94]
  3. Micael's Avatar
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       #2823  
    Quote Originally Posted by davidra View Post
    All I can say is that I think you underestimate what it requires to keep up with the current literature. There are something like 20,000 articles published each year, just in internal medicine alone. Putting all your trust in a doctor to keep up with all of that, without any external controls on practice or medications, is challenging. And of course, most people aren't as motivated or intelligent as you, and can't bother, and they cost money too.
    Thank goodness that my illness probably won't require I read a whole year's release of current lit! Wouldn't you say that the number might be culled down a wee bit if I just have one grievous malady? Granted, it can still be challenging, even daunting. That's why I'd want to research my caregiver almost as hard as I'll be researching my treatment options. I hope that I can find someone local as well versed and engaged as you, David.
    And if you are suggesting that there be cost controls on pharmaceutical companies in terms of what they charge (and the vast inconsistencies of cost from country to country for the same drug), I totally agree with you. Of course, that requires government control of private industry. Somehow I don't think you really favor that (although I do).
    I'm all for the government getting involved in certain instances that make sense. If the pharmaceutical companies are gouging, let's call them on the carpet. There's a big difference between guard dogging and going after gougers versus regulating and dictating pricing schedules for the whole industry.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
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       #2824  
    Quote Originally Posted by ryleyinstl View Post
    This is how it works in the Canadian Public System....why is it that the proposed US "public" system not include such provisions? ....or rather what makes us think it will not?
    If the choice is taken away by the fed, it's moot.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  5. #2825  
    Quote Originally Posted by Micael View Post
    If the choice is taken away by the fed, it's moot.
    Is there anything you've read that suggests a US universal plan would do that? The fact is that for-profit plans are more restrictive about doctor choice than Medicare. There is no "network" in Medicare. You have your choice of any doctor that takes it.
  6. #2826  
    Although I have no love for the current system you could argue that it isn't broken. Buy insurance, get treatment. It was how it was designed and it's working for me.

    In the USA you need to insure your car, you're required to insure your house if you're mortgaging it and you're expected to have health insurance. Pretty straightforward really. Get with the program and buy insurance.
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  7. #2827  
    Quote Originally Posted by ryleyinstl View Post
    Although I have no love for the current system you could argue that it isn't broken. Buy insurance, get treatment. It was how it was designed and it's working for me.

    In the USA you need to insure your car, you're required to insure your house if you're mortgaging it and you're expected to have health insurance. Pretty straightforward really. Get with the program and buy insurance.
    Yeah? Glad it works for you. Guess you are one of the 80% of workers who can get insurance through their work. The other 20% can't, and can't afford their own. So who takes care of them? Or should we just turn them away?

    The system isn't broken. There is no system.
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       #2828  
    Quote Originally Posted by davidra View Post
    Yeah? Glad it works for you. Guess you are one of the 80% of workers who can get insurance through their work. The other 20% can't, and can't afford their own. So who takes care of them? Or should we just turn them away?

    The system isn't broken. There is no system.
    ltm ltm lol ltm here we go again!

    David, please. There are options for that 20%. We've been over and over this. Yes, these options can be improved. Yes, there's abuses in insurance that need to be addressed.

    Since we're recycling, I'll say it one more time. The vast majority of savings in healthcare IS NOT in the insurance end. It's massive gouging that occurs in the services and materials (drugs included). I don't know that regulation is the answer there, either. I think that if the patient was able to see what they are being charged.... all the little things that go in to a treatment engagement, and allowed to "shop price", so to speak, prices would drop through the roof. Free markets actually work.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  9. #2829  
    Many of the few people I know without health coverage could afford it if they made the decision to afford it....but because no one is making them buy the coverage they don't.
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    #2830  
    Quote Originally Posted by davidra View Post
    Yeah? Glad it works for you. Guess you are one of the 80% of workers who can get insurance through their work. The other 20% can't, and can't afford their own. So who takes care of them? Or should we just turn them away?

    The system isn't broken. There is no system.
    Gosh, I must not have heath insurance then. I work for myself. Oh, wait, YES I DO and have had health insurance from DAY 1 that I made a CHOICE to purchase. Because of that choice, I had to live in a dumpy 420 sqft apartment until my business improved. How often did I use that insurance? Twice. But I felt that it was that important for me to have insurance.

    And since this is all just a repeat of what has been said again and again and again...if you want to see the actual costs of heath care go down, make heath insurance illegal and make everyone pay out of their own pocket rather than some other entity magically paying for it.

    Then, lets see who can and cannot afford what and who really "needs" this or that. Those who cannot afford something that they "need" can then be subjected to all things that are so wonderful about government assistance. Don't drag the rest of us into your quagmire of rising costs and arbitrary limitations.
  11. #2831  
    Quote Originally Posted by davidra View Post
    Is there anything you've read that suggests a US universal plan would do that? The fact is that for-profit plans are more restrictive about doctor choice than Medicare. There is no "network" in Medicare. You have your choice of any doctor that takes it.
    Now that is kind of crazy statement, "There is no network in Medicare. You have your choice of any doctor that takes it." Ummmm....that statement just makes no sense. Maybe it isn't called a "network", but, if you can only go to a certain number of physicians to get benefits, that sure seems like a network to me. If it walks like a duck, and quacks like a duck....I'm going to call it a duck.

    And, I might add, more and more doctors are opting out of taking medicare patients. You always say it isn't true, or that these doctors are stupid to cut out this business, but if they can't make money accepting what the government wants to pay them, what choice do they have? I have spoken to people who have told me they have fewer doctors to choose from. You see, their office is not run like the government where they can stay open if they take in less money than their expenses. So, they (unlike the government) make decisions (stop taking medicare patients) so they can stay open. Of course, they also don't need to gouge their non-medicare patients either (like my $800 back brace and the many examples in that article you promoted), so there should be a happy medium where doctors can make a reasonable income and keep their charges at a reasonable level.
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  12. #2832  
    Quote Originally Posted by ryleyinstl View Post
    Many of the few people I know without health coverage could afford it if they made the decision to afford it....but because no one is making them buy the coverage they don't.
    I tend to agree with you.....I wonder how many people who say they can't afford coverage have the full cable package, or the unlimited mobile phone service, or a boat payment, etc. They could also get a plan that has a high deductible that will at least limit their exposure to a catastrophic bill, but, they often only want it if they have unlimited co-pays for visits and medications. People do have priorities for sure. However, I do see people who simply can't afford it. I won't launch into my plan again, but there are ways this can be addressed, get the unhealthy covered, help supplement their premiums, and the federal government is really not involved (because, it really isn't the business of the Federal Government).
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  13. #2833  
    Quote Originally Posted by clemgrad85 View Post
    Now that is kind of crazy statement, "There is no network in Medicare. You have your choice of any doctor that takes it." Ummmm....that statement just makes no sense. Maybe it isn't called a "network", but, if you can only go to a certain number of physicians to get benefits, that sure seems like a network to me. If it walks like a duck, and quacks like a duck....I'm going to call it a duck.

    And, I might add, more and more doctors are opting out of taking medicare patients. You always say it isn't true, or that these doctors are stupid to cut out this business, but if they can't make money accepting what the government wants to pay them, what choice do they have? I have spoken to people who have told me they have fewer doctors to choose from. You see, their office is not run like the government where they can stay open if they take in less money than their expenses. So, they (unlike the government) make decisions (stop taking medicare patients) so they can stay open. Of course, they also don't need to gouge their non-medicare patients either (like my $800 back brace and the many examples in that article you promoted), so there should be a happy medium where doctors can make a reasonable income and keep their charges at a reasonable level.
    I say it's not true because it's not true. 75-80% of doctors take new Medicare patients. Do you really not think that is a larger network than any health plan or HMO? I know you'd like to think that Medicare patients can't get the care they want or need....but it's funny how Medicare participants disagree strongly with you. Why? Because you're wrong. Again.
  14. #2834  
    Quote Originally Posted by Micael View Post
    ltm ltm lol ltm here we go again!

    David, please. There are options for that 20%. We've been over and over this. Yes, these options can be improved. Yes, there's abuses in insurance that need to be addressed.

    Since we're recycling, I'll say it one more time. The vast majority of savings in healthcare IS NOT in the insurance end. It's massive gouging that occurs in the services and materials (drugs included). I don't know that regulation is the answer there, either. I think that if the patient was able to see what they are being charged.... all the little things that go in to a treatment engagement, and allowed to "shop price", so to speak, prices would drop through the roof. Free markets actually work.

    Fine. Take care of the other 20% then. Have you ever priced individual insurance plans? Yeah, only a couple thousand a month if you're perfectly healthy. And currently, if you have ANY preexisting condition, you can't get it at all. Thankfully, that will change thanks to health care reform. And as we've said, you really have no idea how unlikely it is that a free market will work. Are you ready to pay $8000 for a routine appendectomy? Oh, that's covered by your $3000 a month policy? Then how about just a few thousand for some lab tests and an MRI. Oh....you're a health care worker, 40 hours a week without insurance, and you make barely enough for your rent?

    You seem to think that just by making people pay for things themselves the price will come down. I am confident it won't. When services can no longer be supported by income, they disappear and are no longer offered....even if essential. The horse is out of the barn. Our country has allowed health care costs to get so high that at this point there is no way to force payment on individuals. That might work for routine care....but not if you get sick.
  15. #2835  
    Quote Originally Posted by rjwerth View Post
    Gosh, I must not have heath insurance then. I work for myself. Oh, wait, YES I DO and have had health insurance from DAY 1 that I made a CHOICE to purchase. Because of that choice, I had to live in a dumpy 420 sqft apartment until my business improved. How often did I use that insurance? Twice. But I felt that it was that important for me to have insurance.

    And since this is all just a repeat of what has been said again and again and again...if you want to see the actual costs of heath care go down, make heath insurance illegal and make everyone pay out of their own pocket rather than some other entity magically paying for it.

    Then, lets see who can and cannot afford what and who really "needs" this or that. Those who cannot afford something that they "need" can then be subjected to all things that are so wonderful about government assistance. Don't drag the rest of us into your quagmire of rising costs and arbitrary limitations.
    And how old were you then? And did you have any preexisting conditions? And what percentage of your monthly income went to pay your insurance? Do you even know that most insurance for individuals now costs more than rent? A lot more?

    And if you really think you can afford to pay for your own hospitalizations out of your pocket, go for it. But before you do, look over the average hospital bill. Yeah, you might be fine and be killed by a bus and die before you get to the hospital...because if you survive you're screwed, bucko.
  16. Micael's Avatar
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       #2836  
    Quote Originally Posted by davidra View Post
    Fine. Take care of the other 20% then. Have you ever priced individual insurance plans? Yeah, only a couple thousand a month if you're perfectly healthy. And currently, if you have ANY preexisting condition, you can't get it at all. Thankfully, that will change thanks to health care reform. And as we've said, you really have no idea how unlikely it is that a free market will work. Are you ready to pay $8000 for a routine appendectomy? Oh, that's covered by your $3000 a month policy? Then how about just a few thousand for some lab tests and an MRI. Oh....you're a health care worker, 40 hours a week without insurance, and you make barely enough for your rent?

    You seem to think that just by making people pay for things themselves the price will come down. I am confident it won't. When services can no longer be supported by income, they disappear and are no longer offered....even if essential. The horse is out of the barn. Our country has allowed health care costs to get so high that at this point there is no way to force payment on individuals. That might work for routine care....but not if you get sick.
    The bigest fallacy (aka lie) of the "health care reform" act is that all of this will now be taken care of, and magically cost us all less money.

    Good luck with that.
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  17. #2837  
    Quote Originally Posted by Micael View Post
    The bigest fallacy (aka lie) of the "health care reform" act is that all of this will now be taken care of, and magically cost us all less money.

    Good luck with that.
    Not now...but it will be much better in 2014 when insurance companies will have to control their rates in order to stay in the exchange. And as for me, I've never fantasized that costs would be controlled by this weak bill. It needs much more rigor. Dems had to do what they had to do, but the bill needs much work.
  18. #2838  
    Quote Originally Posted by davidra View Post
    Not now...but it will be much better in 2014 when insurance companies will have to control their rates in order to stay in the exchange. And as for me, I've never fantasized that costs would be controlled by this weak bill. It needs much more rigor. Dems had to do what they had to do, but the bill needs much work.
    Well hopefully we get more Republicans in office this Nov and they can hang on until Obama is voted out in 2012 and we can get this "weak bill" (the doc's words, I love it!) repealed and actually get a bill that will control costs. This false hope of letting everyone in by 2014 to control costs is just extremely stupid thinking. Besides, this "penalty" that the government will impose on you if you don't have health insurance is just way too low. The penalty will be lower than for them to buy health insurance. If these folks have any brains (which is questionable since many of them voted for obama) they will pay the penalty and just buy the health insurance when they need it. Since there will be no pre-ex issues, no big deal.

    I'd again like to add.....people voted for a man who never ran anything in his life and we got exactly what they voted on. What is surprising is that he apparently doesn't even have the brains to get people around him that can help him. Hey doc, haven't seen you pushing those gallup polls much lately....but I'm sure you'd want to know that obama has now hit a new low, 42%: Obama Sees New Lows in Job Approval

    What this means is that only the hard core democrats think he is worth a darn. The independents have been jumping like rats from a sinking ship. I am amazed at the people that I talk to who voted for him in 2008 and say "never again." I think he has a chance to challenge Carter when it is all said and done.
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  19. #2839  
    Quote Originally Posted by clemgrad85 View Post
    Well hopefully we get more Republicans in office this Nov and they can hang on until Obama is voted out in 2012 and we can get this "weak bill" (the doc's words, I love it!) repealed and actually get a bill that will control costs. This false hope of letting everyone in by 2014 to control costs is just extremely stupid thinking. Besides, this "penalty" that the government will impose on you if you don't have health insurance is just way too low. The penalty will be lower than for them to buy health insurance. If these folks have any brains (which is questionable since many of them voted for obama) they will pay the penalty and just buy the health insurance when they need it. Since there will be no pre-ex issues, no big deal.

    I'd again like to add.....people voted for a man who never ran anything in his life and we got exactly what they voted on. What is surprising is that he apparently doesn't even have the brains to get people around him that can help him. Hey doc, haven't seen you pushing those gallup polls much lately....but I'm sure you'd want to know that obama has now hit a new low, 42%: Obama Sees New Lows in Job Approval

    What this means is that only the hard core democrats think he is worth a darn. The independents have been jumping like rats from a sinking ship. I am amazed at the people that I talk to who voted for him in 2008 and say "never again." I think he has a chance to challenge Carter when it is all said and done.
    Doesn't make a difference to me. A lot of the dissatisfaction is coming from his base because of Afghanistan and DADT, Gitmo and other things. The thing about that population is they will end up voting for him regardless; they sure as hell won't vote for Palin. As I recall he is somewhat behind a generic republican but leads all republicans head to head by a pretty good majority. It would be different if there was a real republican challenger, but there isn't and I don't see one. The right hates Romney because of his relligion and he flipflops more than anyone, like on health care; Palin is a mental dwarf and even republicans don't think she can get elected. Huckabee? Right, sure. He'll get the evangelist vote. I don't see anyone close, actually. And even if he is a one term president (and I'll be glad to bet he won't be), he's already done more positive things that Bush did in 8 years....and a lot fewer negative things. I'm pleased as punch with his performance.
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    #2840  
    Quote Originally Posted by davidra View Post
    And how old were you then? And did you have any preexisting conditions? And what percentage of your monthly income went to pay your insurance? Do you even know that most insurance for individuals now costs more than rent? A lot more?
    It is so obvious that you have never had to insure yourself and thus have no idea as to what you are talking about. I was 28 and paying $350/month in rent. My 0 deductible health insurance was $250. At the time, I was only taking home $1000-$1500 a month.

    I have recently changed my insurance due to the rising costs, so while I no longer have a 0 deductible, I'm still paying around $300/month. Now, I don't know where you live, but if your rent is less than $300/month..more power to you.

    And if you really think you can afford to pay for your own hospitalizations out of your pocket, go for it. But before you do, look over the average hospital bill. Yeah, you might be fine and be killed by a bus and die before you get to the hospital...because if you survive you're screwed, bucko.
    Could I pay for medical costs at the current system rates out of my pocket? No, probably not. But that's my point. There are too many people out there who do not pay for their heath insurance getting crazy good policies and using every inch of them and thus driving up the cost for EVERYONE. If everyone paid everything out of pocket, it would not cost $10,000 to have a baby because no one would pay it.

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