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  1.    #1  
    If you think that it's the government that is primarily responsible for excess health care costs, and if you are willing to spend some time reading a fairly long article, please read this article by Atul Gawande. Why would a small Texas town (McAllen) have significantly higher Medicare costs than other, similarly-sized towns? Could it possibly be the fault of the free market? Atul researched all the possible reasons. This is an excellent article that everyone who cares about health care should read.

    Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coördination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.
    This last point is vital. Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks. Here’s how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some “skin in the game,” and then they’ll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes. You get McAllen.


    Read more McAllen, Texas and the high cost of health care : The New Yorker
  2. #2  
    average age of the population? Proximity to oklahoma? LTM
  3. #3  
    I think the arguement is based on a faulty premise. That excess cost is the responsibility of the government. Seeing that the government has not unless it takes away, then you are saying that we the people are responsible for paying the excess whether through increased Medicare taxes or migrating to a single payer. This is patently false.

    I might go along with you if you brought up cost controls wherein a hospital can no longer charge 700 bucks per night for a hospital visit...

    No, you wouldn't want to go there at all because affordable healthcare in your mind only means that the government helps you afford the inflated costs. This is absurd. What money is there that could/would cover these costs?

    How many people would walk into a store/pharmacy and pay 10 bucks per bandage? Or 20 bucks a dose of Tylenol? It is clear that what needs to happen is for "market" forces inside our healthcare aparatus to fall in line with true market forces outside.

    You want affordable healthcare? Me too, but not on the backs of hardworking Americans who did nothing but make more money than you think they should have.
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  4. #4  
    +1
  5.    #5  
    Quote Originally Posted by pogeypre View Post
    I think the arguement is based on a faulty premise. That excess cost is the responsibility of the government. Seeing that the government has not unless it takes away, then you are saying that we the people are responsible for paying the excess whether through increased Medicare taxes or migrating to a single payer. This is patently false.

    I might go along with you if you brought up cost controls wherein a hospital can no longer charge 700 bucks per night for a hospital visit...

    No, you wouldn't want to go there at all because affordable healthcare in your mind only means that the government helps you afford the inflated costs. This is absurd. What money is there that could/would cover these costs?

    How many people would walk into a store/pharmacy and pay 10 bucks per bandage? Or 20 bucks a dose of Tylenol? It is clear that what needs to happen is for "market" forces inside our healthcare aparatus to fall in line with true market forces outside.

    You want affordable healthcare? Me too, but not on the backs of hardworking Americans who did nothing but make more money than you think they should have.
    I'm sorry, but you clearly did not read the article. Why don't you do that, then try again?
  6. Micael's Avatar
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    #6  
    Seriously, we need *another* healthcare thread?
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  7.    #7  
    Quote Originally Posted by Micael View Post
    Seriously, we need *another* healthcare thread?
    Some people are actually interested in educating themselves. Some aren't. Feel free to not respond, and it will go away. You might consider reading the article, however.
  8. thornev's Avatar
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    #8  
    "60 Minutes" had an interesting postulation in one of its stories last Sunday... in my own words, a huge piece of Medicare costs are covering the last 20 days of persons' lives during which the probability of restoring life is close to nill. In other words, we are spending huge amounts of money for keeping people alive beyond a reasonable expectation that they will survive. I vote that "Kavorkianism" become legal. thorne
  9. #9  
    Quote Originally Posted by thornev View Post
    "60 Minutes" had an interesting postulation in one of its stories last Sunday... in my own words, a huge piece of Medicare costs are covering the last 20 days of persons' lives during which the probability of restoring life is close to nill. In other words, we are spending huge amounts of money for keeping people alive beyond a reasonable expectation that they will survive. I vote that "Kavorkianism" become legal. thorne
    Whether this is satire or no.... we now have death panels.
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  10.    #10  
    Quote Originally Posted by thornev View Post
    "60 Minutes" had an interesting postulation in one of its stories last Sunday... in my own words, a huge piece of Medicare costs are covering the last 20 days of persons' lives during which the probability of restoring life is close to nill. In other words, we are spending huge amounts of money for keeping people alive beyond a reasonable expectation that they will survive. I vote that "Kavorkianism" become legal. thorne
    http://forums.precentral.net/off-top...g-grandma.html
  11. #11  
    Quote Originally Posted by pogeypre View Post
    I think the arguement is based on a faulty premise. That excess cost is the responsibility of the government. Seeing that the government has not unless it takes away, then you are saying that we the people are responsible for paying the excess whether through increased Medicare taxes or migrating to a single payer. This is patently false.

    I might go along with you if you brought up cost controls wherein a hospital can no longer charge 700 bucks per night for a hospital visit...

    No, you wouldn't want to go there at all because affordable healthcare in your mind only means that the government helps you afford the inflated costs. This is absurd. What money is there that could/would cover these costs?

    How many people would walk into a store/pharmacy and pay 10 bucks per bandage? Or 20 bucks a dose of Tylenol? It is clear that what needs to happen is for "market" forces inside our healthcare aparatus to fall in line with true market forces outside.

    You want affordable healthcare? Me too, but not on the backs of hardworking Americans who did nothing but make more money than you think they should have.

    Very good points, however, I have noticed a bit of a problem with your free market system. The biggest one being the corps, regardless to who they are, will do damn near anything to keep their stock holders happy. It was brought up prior to the whole health care thing down there about death panels.. then you find out.. that the insurance companies al ready had them.. that they just disallowed people from coverage. free market, well it would be fine, except you/ we have corps out there that view people as a commodity, not much more then a side of beef to take what they can from them, at any cost. so govt controls of yours and my system is there, hell its required.
    if a nurse or care giver decides that a given person is too ill and with holds treatment and the sick person dies, that murder, is the same being said of the insurance companies that will drag their feet in courts in the hope they dont have to pay out the cost of the treatments. hell there is no difference. Murder is murder.. but hey .. im just saying
    Life is short, Play hard, and enjoy every moment as if it was your last.
  12.    #12  
    Quote Originally Posted by xForsaken View Post
    Very good points, however, I have noticed a bit of a problem with your free market system. The biggest one being the corps, regardless to who they are, will do damn near anything to keep their stock holders happy. It was brought up prior to the whole health care thing down there about death panels.. then you find out.. that the insurance companies al ready had them.. that they just disallowed people from coverage. free market, well it would be fine, except you/ we have corps out there that view people as a commodity, not much more then a side of beef to take what they can from them, at any cost. so govt controls of yours and my system is there, hell its required.
    if a nurse or care giver decides that a given person is too ill and with holds treatment and the sick person dies, that murder, is the same being said of the insurance companies that will drag their feet in courts in the hope they dont have to pay out the cost of the treatments. hell there is no difference. Murder is murder.. but hey .. im just saying
    The point of the article is that there is plenty of blame to go around...and that it really is shortsighted to exclude physicians from the discussion.
  13. #13  
    Thanks obama care! Received word yesterday from BC/BS of SC, and just received an email this morning from Aetna, that they will discontinue "child only policies". The reason? "This change positions Aetna for the future so we can effectively handle upcoming changes resulting from healthcare reform." After discussing the rules requiring guaranteed issue of coverage for individuals under the age of 19, they go on to say "These conditions have the potential to significantly increase the cost of premiums and make coverage unaffordable." In other words, they can't afford to cover children without underwriting without raising the rates to even higher rates, so, why do it. So, this effectively penalizes the majority to help those in the minority. This is the problem with obama care, from the beginning it was like throwing mud against a wall, seeing what they could get to stick (pass), and it really doesn't help the situation. Their efforts were to help the uninsured even if it meant penalizing those that are fine with their current coverage. But....at least they could claim they passed healthcare reform. After all, that's what really matters.
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  14.    #14  
    Quote Originally Posted by clemgrad85 View Post
    Thanks obama care! Received word yesterday from BC/BS of SC, and just received an email this morning from Aetna, that they will discontinue "child only policies". The reason? "This change positions Aetna for the future so we can effectively handle upcoming changes resulting from healthcare reform." After discussing the rules requiring guaranteed issue of coverage for individuals under the age of 19, they go on to say "These conditions have the potential to significantly increase the cost of premiums and make coverage unaffordable." In other words, they can't afford to cover children without underwriting without raising the rates to even higher rates, so, why do it. So, this effectively penalizes the majority to help those in the minority. This is the problem with obama care, from the beginning it was like throwing mud against a wall, seeing what they could get to stick (pass), and it really doesn't help the situation. Their efforts were to help the uninsured even if it meant penalizing those that are fine with their current coverage. But....at least they could claim they passed healthcare reform. After all, that's what really matters.
    Thanks again for bringing up your hatred for Obama and his policies in a thread that has nothing whatsoever to do with the health plan. We get it. You don't like his health plan. Now if you only actually knew something about health care costs. Why not doing your best to read the article, which I have no doubt you didn't do; you will see that it gives a pretty good explanation for high costs....and it isn't the health plan at fault. Just please do your best to pay attention.
  15. sweaner's Avatar
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    #15  
    Davidra, so, in McAllen, did no one have insurance, and the free market actually determined the spending and costs?
  16.    #16  
    Quote Originally Posted by sweaner View Post
    Davidra, so, in McAllen, did no one have insurance, and the free market actually determined the spending and costs?
    The "free market", i.e. the physicians and hospitals, used many more procedures/tests/devices than comparable areas, and that extra care did not show any improvement in outcomes. While all these payments were allowed by both private insurers and Medicare, they were excessive, which resulted in twice the national average in Medicare payments (which was one data base they could track, not having access to private company records). How do you correct it? Make sure that things that are used are cost-effective and result in better outcomes. But for some reason, people see that as rationing, or government control of health care. In fact, it's higher quality care.

    If you sprain your knee on the stairs, do you need an MRI? Almost certainly not. Will you get one? Depends on who sees you, whether they are knowledgeable about the fact that MRI's in acute knee sprains do not improve outcomes, and of course if they happen to have a financial interest in buying the MRI machine. That's the reality. And the point is that it doesn't make any difference whether it's Medicare or BCBS paying, it still increases health care costs dramatically. We need to practice evidence-based medicine.
  17. #17  
    Quote Originally Posted by davidra View Post
    Thanks again for bringing up your hatred for Obama and his policies in a thread that has nothing whatsoever to do with the health plan. We get it. You don't like his health plan. Now if you only actually knew something about health care costs. Why not doing your best to read the article, which I have no doubt you didn't do; you will see that it gives a pretty good explanation for high costs....and it isn't the health plan at fault. Just please do your best to pay attention.
    Your track record of only presenting liberal views on anything and your hatred towards anyone on the right is what prevents people from reading anything you post. I mean, why don't we just turn on MSNBC or CNN? It's the same BS there that appears in your articles. And, you are right in line with liberal talking points of again labeling anyone who is opposed to anything the almighty obama says as being hatred.

    I understand you not being able to explain how obama care is doing the complete opposite of what it was supposed to do. It must be getting more and more difficult to explain anything that comes from this administration. By the way, how are obama's polls going these days? I don't think anyone has divided this country more than obama. I mean seriously, how stupid is it to send your wife on a luxurious trip to Spain at this time? Especially when he thinks about everyone who is hurting just before he goes to bed and the first thing when he wakes up in the morning. I wonder who thought, "you know, if we send Michelle to Spain like royalty, maybe folks won't be so critical." ROFL Who is running that sinking ship over there?
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  18.    #18  
    Quote Originally Posted by clemgrad85 View Post
    Your track record of only presenting liberal views on anything and your hatred towards anyone on the right is what prevents people from reading anything you post. I mean, why don't we just turn on MSNBC or CNN? It's the same BS there that appears in your articles. And, you are right in line with liberal talking points of again labeling anyone who is opposed to anything the almighty obama says as being hatred.

    I understand you not being able to explain how obama care is doing the complete opposite of what it was supposed to do. It must be getting more and more difficult to explain anything that comes from this administration. By the way, how are obama's polls going these days? I don't think anyone has divided this country more than obama. I mean seriously, how stupid is it to send your wife on a luxurious trip to Spain at this time? Especially when he thinks about everyone who is hurting just before he goes to bed and the first thing when he wakes up in the morning. I wonder who thought, "you know, if we send Michelle to Spain like royalty, maybe folks won't be so critical." ROFL Who is running that sinking ship over there?
    If you want to regurgitate your Fox talking points, please start your own thread that I can ignore. This thread was not about Obama, not about his wife taking a trip, and not about political polls. How do I know that you haven't read the article? Because you would agree with much of it, but you are too lazy to even read it.

    Try for just a tad bit of reason about the topic that was raised. I know it's a struggle, but just give it a try.
  19. #19  
    if there is one thing I have learned on this site.. It's that people will only recognize what they want to. They will take any opportunity to push their agenda... And they will spin, avoid, and deny anything that goes against what the WANT to believe.

    there are a selected few that will only scan a thread or a post for anything they can argue against.

    the problem for most is if you believe in something....its hard to open up and accept you maybe wrong....
    some people have deep underlying bias... That they don't even realize how they come off.
    what I hate is others spending hours trying to push their agenda's... On a site specifically targeting a product or agenda that opposes theirs. They will spin, avoid, deny, discredit...and repeat.
    there is no point in debating those users... Other than to call them out on their intentions and motivations... And expose them for what they are.... Fill in the blank.
    the fact that they are anonymous.... Makes the problem worse.

    "bernie G"
    I didn't mean to get off topic... But ...
  20. sweaner's Avatar
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    #20  
    Quote Originally Posted by davidra View Post
    The "free market", i.e. the physicians and hospitals, used many more procedures/tests/devices than comparable areas, and that extra care did not show any improvement in outcomes.
    That IS NOT the free market! The free market would be that only if the patients were the ones actually paying the bills. That is 1/2 of a free market.

    If people went to a supermarket, and the bill was paid by a 3rd party, don't you think the fish man would load the carts up with lobster? And don't you think the shopper would gladly take it home?
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