-
Medicare For All
How do folks here feel about Medicare For All?
-
1 Reply
-
Id ignore this thread completely.
-
Removed due to GDPR request
-
Healthy organic food for all.
-
It’s a great piece of paper.
-
I feel more confident in AI replacing us than I do about Medicare for all passing Congress in our lifetimes
-
It’ll be Medicare / 2 within 2 decades for most of the 65+ anyway. Haha, Medicare for all, even though we’re broke as foke
-
I would suggest spending what you have now instead of worrying how fast until $1M. It will soon all be taken away from you to fund Medicare.
-
Quote from Thread killer
I would suggest spending what you have now instead of worrying how fast until $1M. It will soon all be taken away from you to fund Medicare.
Why do you say this?
-
Quote from drad123
Quote from Thread killer
I would suggest spending what you have now instead of worrying how fast until $1M. It will soon all be taken away from you to fund Medicare.
Why do you say this?
Maybe they had a bank account in Cyprus? Key word being had. -
Quote from drad123
Quote from Thread killer
I would suggest spending what you have now instead of worrying how fast until $1M. It will soon all be taken away from you to fund Medicare.
Why do you say this?
Trolling like the OP.
-
-
-
-
-
-
-
-
-
TK, funny name and stuff
-
Healthcare is a human right
-
Quote from irfellowship2020
Healthcare is a human right
What is the definition of human right?What else is human right?
-
if you doubt the OP is a troll, just read the rest of his posts. Started on 7/10 asking what we all thought about a job as CMO with a silicon valley start up, and proceeded along the troll path on all subsequent posts.
-
Quote from Hospital-Rad
Quote from irfellowship2020
Healthcare is a human right
What is the definition of human right?
What else is human right?
You won’t get an intelligent answer. Let me guess, it’ll be some emotional appeal to some vague ideal such as “fairness”, which always ends up being whatever the beholder wants it to be, changing also over time, and showing that they were never interested in real ideas or principles.-
The right to health is a fundamental part of our human rights and of our understanding of a life in dignity. The right to the enjoyment of the highest attainable standard of physical and mental health, to give it its full name, is not new. Internationally, it was first articulated in the 1946 Constitution of the World Health Organization (WHO), whose preamble defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The preamble further states that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
-
Medicare for all platform will get Trump re-elected. Saving obamacare platform has a shot to win.
-
A right is something that exists if you were the last person on earth. It’s something that can be protected. It’s not something provided. Everything else is a privilege. Labeling a privilege as a right would require taking away someones right to freedom to provide for someone else. This discussion (here and outside the forum) makes no sense.
-
Quote from ztune
A right is something that exists if you were the last person on earth. It’s something that can be protected. It’s not something provided. Everything else is a privilege. Labeling a privilege as a right would require taking away someones right to freedom to provide for someone else. This discussion (here and outside the forum) makes no sense.
This bears repeating, and re-reading.
Well done ztune.-
Lol in that guardian article they quote an nhs rad as saying turnaround times have gone from 1 week to over a month. I cant imagine the shitstorm that would happen if we were taking 1 week on turnaround time, or even 4 days
-
Quote from Intermittent Blasting
Quote from ztune
A right is something that exists if you were the last person on earth. It’s something that can be protected. It’s not something provided. Everything else is a privilege. Labeling a privilege as a right would require taking away someones right to freedom to provide for someone else. This discussion (here and outside the forum) makes no sense.
This bears repeating, and re-reading.
Well done ztune.
[b]Rights[/b] are legal, social, or ethical principles of freedom or entitlement; that is, rights are the fundamental normative rules about what is allowed of people or owed to people, according to some legal system, social convention, or ethical theory. wiki
No sense talking about rights if one is the last person on earth.-
What you’re not making is the mental jump to the next step of understanding that as Americans we have, and should treasure, negative rights and the enlightened men that chose to make them that way due to their knowledge of history and brilliant minds. That means that anything added to the constitution beyond this is actually, in essence, anti-American. Made up ideas through judicial activism or stealth additions through code are precisely that. The Constitution is clear about this, and the best example is the ignoring of the tenth amendment via the idiotic “interpretation” of the commerce clause rendering an actual “amendment” of the Bill of Rights void, 99% of the time.
-
I, too, feel that a few dozen white supremacist slave owners that lived prior to electricity are infallible and should have any say whatsoever in how we should run our government or society.
-
Ensuring some minimum level of food, shelter and health for people in our borders. Truly, who are the real victims here?
-
Quote from deadwing
I, too, feel that a few dozen white supremacist slave owners that lived prior to electricity are infallible and should have any say whatsoever in how we should run our government or society.
Idiotic response with no sense or respect at all for the men that created the country that every race in the world [b]still [/b]wants to come to, although you support people actively ruining it.
I’d love to see you post on the supremacist and slave behaviors of every other race of mankind, but I know I’ll never see that. They were much worse actors, too. Your level of historical understanding can’t be shamed enough. -
Quote from Intermittent Blasting
What you’re not making is the mental jump to the next step of understanding that as Americans we have, and should treasure, negative rights and the enlightened men that chose to make them that way due to their knowledge of history and brilliant minds. That means that anything added to the constitution beyond this is actually, in essence, anti-American. Made up ideas through judicial activism or stealth additions through code are precisely that. The Constitution is clear about this, and the best example is the ignoring of the tenth amendment via the idiotic “interpretation” of the commerce clause rendering an actual “amendment” of the Bill of Rights void, 99% of the time.
Not sure I am following your train of thought but I think you are addressing the conflict between positive and negative liberty. Human values are often at odds with each other. Life is trade-offs. Conflating values gets us nowhere. Balancing values is the key.
By the way, constitutionalism is contractarian, a form of positive liberty.
-
-
-
-
-
Quote from irfellowship2020
The right to health is a fundamental part of our human rights and of our understanding of a life in dignity. The right to the enjoyment of the highest attainable standard of physical and mental health, to give it its full name, is not new. Internationally, it was first articulated in the 1946 Constitution of the World Health Organization (WHO), whose preamble defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The preamble further states that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
Beautiful. Who decides how that is provided and who pays?
-
If only people actually cared about investing in people instead of always themselves.
-
Quote from Thread killer
Quote from irfellowship2020
The right to health is a fundamental part of our human rights and of our understanding of a life in dignity. The right to the enjoyment of the highest attainable standard of physical and mental health, to give it its full name, is not new. Internationally, it was first articulated in the 1946 Constitution of the World Health Organization (WHO), whose preamble defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The preamble further states that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
Beautiful. Who decides how that is provided and who pays?
Who decides now? You think it is the individual patient? You think there is individual freedom? No.
-
-
-
-
-
-
-
Aside from our military caste, self-interest has become a virtue if not a defining feature of the modern American. Any expectation of individual expense, sacrifice or even inconvenience for the common good is likely to be derided as naive or antiquated. Its a gap in understanding that is hard to bridge with words, and makes this topic hard to discuss. To paraphrase Goro in The Yakuza (1974) when he talks about the sense of Giri (Japanese understanding of obligation) that Robert Mitchums character is seeking clarity on,
If you dont feel it…you dont have it.
-
Everyone deserves dignity, liberty, and due process of law in the United States.
-
Also a really beautiful, good sounding sentence. However, you ducked the question posed to you! Ill write it again. B Who decides how that is provided and who pays?
-
[b][b][b]70 percent Top Tax Bracket for Ordinary Income and Capital Gains Income
[b]77 Percent Death Tax on estates[/b][/b][/b][/b]
[b][b][b][b][b]Wealth Tax on assets
[b]Bank Tax[/b]
[b]Broaden the Self Employment Tax[/b][/b][/b]
[/b][/b][/b]-
Quote from irfellowship2020
[b][b][b]70 percent Top Tax Bracket for Ordinary Income and Capital Gains Income
[b]77 Percent Death Tax on estates[/b][/b][/b][/b]
[b][b][b][b][b]Wealth Tax on assets
[b]Bank Tax[/b]
[b]Broaden the Self Employment Tax[/b][/b][/b]
[/b][/b][/b]
Dalai –
I think he is being sarcastic.
70% tax on income then “wealth” tax on what is left – like ?? 30%. Leaves a person with zero.
has to be sarcasm.
well played IR2020
-
We have been infiltrated again by a non physician
-
-
-
What most of the fear mongers don’t realize is that the money to pay for it is already in the system. Where do you think the money comes from that pays the private health insurance companies? The health insurance fairy? If the company you work for pays your health insurance, they are not doing it out the goodness of their heart or charity. It is part of your salary and compensation that you just never see. It goes straight to Blue Cross, UHC, Aetna, etc. How much money do you think they collect from us each year? Trillions. Just pay the employees that amount, and have it deducted out of the paycheck, like income taxes, FICA and the medicare you ALREADY pay. It doesn’t cost the company any more, it doesn’t cost you anymore. Anyone that works for themselves pays for their health insurance out of their own pocket. Pay it to Medicare instead.
The money will just be transferred in a different way to a different insurance company, one big one, Medicare. All of us are paying multiple thousands of $$$ yearly in one way or another for our own health insurance PLUS for the health insurance of all Americans 65 and over. Medicare for senior citizens now is not free. It is paid in part out of their social security checks, which all of us pay as well.
Please understand this concept: No one’s health insurance is FREE! Someone is paying lots of money for it right now, and that person is YOU!
Ask any senior citizen, they love their medicare. Ask your billing people, they like it too. They get paid for every case. You will never see another uncollected invoice due to no insurance. It would be cheaper to administer. No CEO salaries, no profit motive, no shareholders. If you don’t want it, a provision could be made to opt out, and use the money you ALREADY spend to buy a private practice plan. I’d bet the PP insurance companies would have to become more competitive or fail. Me, I’d take the Medicare for all.-
Most people could have guessed that I’m primarily a markets guy, but when you have corrupted systems such as ours, and Dr. Who points this out, us reasonable people can have a legit discussion about it.
The problem is that usually we’re the only ones willing to have it.-
I have a question which I have not seen addressed regarding Medicare for All. A bit of preamble:
A variety of websites touting universal health care compare the amount of money spent per patient in the US to that spent in other countries. Of course, the US outspends other countries on a per patient basis by a wide margin. And yet, the various Medicare for All proposals lose support when their proponents mention the multi-trillion dollar price tags.
So my question is, if we are already outspending other countries by a huge margin, why do we have to increase taxes at all?
-
I believe that was the point Warren was making, wasn’t it?Part of savings was to reduce administrative costs as 1 example. The other things would be regulating costs so that there would be something of a standard rather the present system of charging the Medicare rate 2x-3x by 1 institution while the neighboring institution charges – and receives 5x and higher the rate. But of course that information until you have the procedure actually performed is proprietary and therefore unknowable to the patient. Make procedure costs public just as a start. It is how UHC countries keep their costs down to 1/2 of ours.
It’s the profiteering. Never wonder why the private investors have increased involvement in healthcare? Money & profits.-
But why the trillions and trillions in additional taxes?
-
-
-
-
Come up with figures rather than speculation and we’ll see.
-
Quote from DoctorDalai
Come up with figures rather than speculation and we’ll see.
How is this? Reality is that costs will shift & that’s where the trillion $ figures over a 10 year period come from.
[link=https://www.crfb.org/blogs/how-much-will-medicare-all-cost]https://www.crfb.org/blog…will-medicare-all-cost[/link]
former Social Security and Medicare Trustee and current Mercatus Center fellow [link=https://www.mercatus.org/system/files/blahous-costs-medicare-mercatus-working-paper-v1_1.pdf]Chuck Blahous estimated[/link] that Medicare for All as proposed in Senator Sanders’s 2017 legislation would cost the federal government $27.7 trillion through 2028 assuming steep provider cuts and $32.1 trillion assuming no provider cuts (these estimates, like most others, assume immediate implementation).
[b]Importantly, these totals represent the increased [i]cost to the federal government[/i], not the change of total national health expenditures. National health expenditures would likely change by no more than a few trillion dollars over the decade.[/b] The direction of that change is unclear and would depending on the whether the increased cost of expanding coverage (by making health insurance more generous and offering it to more people) is larger or smaller than the amount saved from lower provider payments, drug payments, and administrative spending.
[link=https://www.nytimes.com/interactive/2019/04/10/upshot/medicare-for-all-bernie-sanders-cost-estimates.html]https://www.nytimes.com/i…rs-cost-estimates.html[/link]
We asked a handful of economists and think tanks with a range of perspectives to estimate total American health care expenditures in 2019 under such a plan. The chart at the top of this page shows the estimates, both in composition and in total cost.
In all of these estimates, patients and private insurers would spend far less, and the federal government would pay far more.
The big differences in the estimates of experts reflect the challenge of forecasting a change of this magnitude; it would be the largest domestic policy change in a generation.
The proposals themselves are vague on crucial points. More broadly, any Medicare for all system would be influenced by the decisions and actions of parties concerned patients, health care providers and political actors in complex, hard-to-predict ways.
Right now, individuals and employers pay insurance premiums; people pay cash co-payments for drugs; and state governments pay a share of Medicaid costs. In a system like one introduced as a bill by Mr. Sanders or another from Representative Pramila Jayapal and the Congressional Progressive Caucus, nearly all of that would be replaced by federal spending. Thats why some experts describe such a system as single-payer.
All of these estimates looked at the potential health care bill under a Sanders-style Medicare for all plan. [b]In some estimates, the country would not pay more for health care, but [u]there would still be a drastic shift in who is doing the paying.[/u] [i]Individuals and their employers now pay nearly half of the total cost of medical care, but that percentage would fall close to zero, and the percentage paid by the federal government would rise to compensate. [/i][/b]
How’s that.
That simply is why these numbers can be so confusing, esp when you start off estimates by saying that the federal government expenditures will increase by $X.00 over 10 years when they mean the costs will shift from individuals and corporations who now pay that $X.00 trillions cost would be transferred to government to pay and manage while forgetting to mention that corporate and individual costs would go down to zero for purchasing insurance.
-
The federal government pays for things by taxing people. So people would still be the ones doing the paying, just through the extra step of being taxed for it,
The federal government also does things like spending $10,000 on toilet seat covers. And yet a group of politicians who routinely run up trillion dollar deficits and who are often criticized for being beholden to lobbyists and various interest groups is going to discover financial frugality if only they are handed control over a massive portion of the countrys GDP.
Santa Claus is a more credible story.
-
But private corporations never overcharge? As I recall those toilet seats were what the private contractor charged the Defense Dept. Right now Amazon’s Cloud for Defense is being opposed, 1 reason being alleged that Amazon would be gouging the government.
If you happen to look up costs of Medicare vs private you will see Medicare costs much less, much of the reason being their administrative costs are much less than private which can cost up to 10% of cost for private vs 3% and less for Medicare. That’s present costs, not toilet seat costs.-
Is that because hospitals charge private more in order to supplement what they make under Medicare?
So if private went away, do you think all of those hospital systems would simply throw up their hands and say well, were out of luck, guess well take the multi billion dollar hit, make less money and fire all our administrators. Or do you think theyd spend a couple hundred million on ads, lobbyists and buying Congresspeople various treats to crank up the Medicare reimbursement rates?
-
Non sequitur. What are you saying? That providers will oppose limiting their charges? That some, esp for-profit hospitals will oppose publishing and limiting their charges?
Isn’t that the point of reducing cost whether M4A or improving the ACA? -
One of the points is reducing costs. That goes back to my original question: why then do we have to raise taxes to reduce costs?
To take one prominent Medicare for All proponent’s plan, Elizabeth Warren’s proposal would spend roughly $52 trillion dollars in the next 10 years on universal health care, which is “just under” the projected $52 trillion the US plans to spend under its current system.
But everyone also says that the US spends way too much already. For instance, the US currently spends about $8000 per capita on healthcare, whereas most other developed countries spend $3000-5000 per capita.
So even after making health care coverage universal in the US, why wouldn’t the total bill go down if the US per capita expenditures went to the level that they are at in other countries? Campaign platform plans by their nature always have the rosiest of projections, but even the rosiest of projections for Medicare for All is still a “maybe we break even” fiscally? -
Quote from radgrinder
One of the points is reducing costs. That goes back to my original question: why then do we have to raise taxes to reduce costs?
To take one prominent Medicare for All proponent’s plan, Elizabeth Warren’s proposal would spend roughly $52 trillion dollars in the next 10 years on universal health care, which is “just under” the projected $52 trillion the US plans to spend under its current system.
But everyone also says that the US spends way too much already. For instance, the US currently spends about $8000 per capita on healthcare, whereas most other developed countries spend $3000-5000 per capita.
So even after making health care coverage universal in the US, why wouldn’t the total bill go down if the US per capita expenditures went to the level that they are at in other countries? Campaign platform plans by their nature always have the rosiest of projections, but even the rosiest of projections for Medicare for All is still a “maybe we break even” fiscally?
Well if you are speaking of M4A, how do you pay? you pay Medicare taxes now. You want to relabel the tax to a subscription?
As for reducing costs, have you read anything about how the UHC countries keep their costs down to 1/2 of ours? That is your answer but it would be highly unlikely to bring our costs down to 1/2 of present costs as it would likely cause a lot of physicians agita. Witness how many already have panic fits over Congressional discussions about reducing costs by reducing Medicare reimbursements without touching anything else, as if physicians’ reimbursement were the only and main cause of the high cost of healthcare. It’s neither physicians’ reimbursement nor obese diabetic patients causing the doubling the cost of some countries, in spite of what some want to believe.
Changing the system we have now is going to be a hard row even by increments as the much simpler ACA has proven, even though most people love it, it’s only “Obamacare” they hate.
Go figure.
-
-
-
-
-
“Jes Suis my butt”. That line is getting really old.
-
-
-
-
-
-
Unfortunately we have gotten to this point because both parties in congress couldnt come together
Obamacare was villified as socialist evil terrible etc.(actually it was a spin off of republican Romney-care)
All it was , was a mechanism to provide coverage to people allowing for choice and using the current system
It was stupid to torpedo it
Both sides should of got together and made as workable as possible
Instead….. we have a political football in which nothing gets done….. the public gets arseFd
…. and we have the new debate which is much more extreme
Nothing accomplished…. physicians continue to get screwed while insurance companies and device makers ring the cash register
Seriously take political affiliations out of this and think about it
-
I mean for the highest tax brackets, not 70% for all income obviously.
[link=https://www.marketwatch.com/story/heres-how-bernie-sanders-says-he-would-fund-medicare-for-all-2019-04-10]https://www.marketwatch.c…are-for-all-2019-04-10[/link]-
Quote from irfellowship2020
I mean for the highest tax brackets, not 70% for all income obviously.
[link=https://www.marketwatch.com/story/heres-how-bernie-sanders-says-he-would-fund-medicare-for-all-2019-04-10]https://www.marketwatch.c…are-for-all-2019-04-10[/link]
Oh, no, a BOINEY supporter! Heaven help us.
Everything I said still applies. Starting with WHO ARE YOU (and BOINEY) to tell anyone they have made too much money and the government MUST confiscate the excess?-
And this is targeting multimillionaires and billionaires, not people like us, so don’t worry.
What services is covered? Whatever medicare covers now. that’s why it’s called medicare for all.-
Quote from irfellowship2020
And this is targeting multimillionaires and billionaires, not people like us, so don’t worry.
.Why?
It is well known if you take EVERYTHING that the top 0.1% or 0.5% make, it will make NO DIFFERENCE whatever. Far too little money to make a dent.
so here is the point:
1) something to enflame the masses so they will vote for the particular enflamer
2) simple expression of ugly jealousy.
-
-
Quote from DoctorDalai
Quote from irfellowship2020
I mean for the highest tax brackets, not 70% for all income obviously.
[link=https://www.marketwatch.com/story/heres-how-bernie-sanders-says-he-would-fund-medicare-for-all-2019-04-10]https://www.marketwatch.c…are-for-all-2019-04-10[/link]
Oh, no, a BOINEY supporter! Heaven help us.
Everything I said still applies. Starting with WHO ARE YOU (and BOINEY) to tell anyone they have made too much money and the government MUST confiscate the excess?
WHO ARE YOU (multinational corporation) to tell anyone how much money they will make while the corporation MUST confiscate the excess?
-
-
-
Dr. S., look at the earlier posts…he ain’t kidding.
kpack, I mostly agree with you, but you can blame the Democrats who DIDN’T ALLOW any discussion on their very flawed bill…”You have to pass it to see what’s in it!” -
Quote from kpack123
Unfortunately we have gotten to this point because both parties in congress couldnt come together
Obamacare was villified as socialist evil terrible etc.(actually it was a spin off of republican Romney-care)
All it was , was a mechanism to provide coverage to people allowing for choice and using the current system
It was stupid to torpedo it
Both sides should of got together and made as workable as possible
Instead….. we have a political football in which nothing gets done….. the public gets arseFd
…. and we have the new debate which is much more extreme
Nothing accomplished…. physicians continue to get screwed while insurance companies and device makers ring the cash register
Seriously take political affiliations out of this and think about it
Private insurance provides no value. Period. It follows medicare to a tee and charges what the market will bear. The current “market system” allows the powerful to exploit- hence the massive consolidation we have been seeing for 30 years. You want more money? Get big and stomp on the little guy.
Obamacare didn’t address the problem- private insurance.-
Quote from drad123
Obamacare didn’t address the problem- private insurance.
It made it worse, actually. All the big players got bigger.
To hand-wave a ‘Medicare for all’ option into existence, it’s safe to assume that the current parasites could not be removed, and the resulting mutant would be better named ‘Medicaid for all’ with the access, quality, and reimbursement that goes with.-
Quote from Adahn
Quote from drad123
Obamacare didn’t address the problem- private insurance.
It made it worse, actually. All the big players got bigger.
To hand-wave a ‘Medicare for all’ option into existence, it’s safe to assume that the current parasites could not be removed, and the resulting mutant would be better named ‘Medicaid for all’ with the access, quality, and reimbursement that goes with.
Bingo. -
Quote from Adahn
Quote from drad123
Obamacare didn’t address the problem- private insurance.
It made it worse, actually. All the big players got bigger.
To hand-wave a ‘Medicare for all’ option into existence, it’s safe to assume that the current parasites could not be removed, and the resulting mutant would be better named ‘Medicaid for all’ with the access, quality, and reimbursement that goes with.
This is why Biden and his ACA 2.0 won’t work. More insurance company revenue is not the answer. Biden doesn’t want to do any work. -just punch a time card at the white house, go to fancy DC dinners, and kiss babies.
-
Quote from Adahn
Quote from drad123
Obamacare didn’t address the problem- private insurance.
It made it worse, actually. All the big players got bigger.
To hand-wave a ‘Medicare for all’ option into existence, it’s safe to assume that the current parasites could not be removed, and the resulting mutant would be better named ‘Medicaid for all’ with the access, quality, and reimbursement that goes with.
-Probably something in between Medicare as we know it today and Medicaid. This is where we need to be.
-
-
Sounds a lot like Radpartners.
-
-
-
You advocate giving the government even greater powers to STEAL from us with some arbitrary level below which the envious are “safe”. Today, Boiney and the other Socialists say that line is at $10M per year. When they can’t raise enough money for their “free stuff” that margin magically becomes $5M. And then $1M, and then….
Yeah, your heroes only want to steal from the “rich”. Right.-
we already have progressive taxes and it’s not stealing. just proposing to make it a bit steeper
-
You might appreciate Hauser’s law:
[link]https://en.wikipedia.org/wiki/Hauser%27s_law[/link]
Population behavior in the face of rising taxes is dynamic not static. You can’t tax your way to health and happiness for all.-
Ugh, you guys/girls took the bait and engaged.
Move it to the off topic forum please.
-
Nobody with sense should really worry about this. It took a little bit of time, but courts have effectively eviscerated obamacare. Younger SCOTUS tend to be conservatives.
[attachment=0][attachment=0]-
A solution doesnt have to be perfect to be effective; it only has to be enough of an improvement over the status quo to be worth implementing. Perfect is the enemy of good, as they say.
Im my own radgrinder, and have not and never will be anyone else.
Merry Christmas and happy holidays to you Frumious, and that is said in the genuine spirit of the season.
-
Quote from radgrinder
A solution doesnt have to be perfect to be effective; it only has to be enough of an improvement over the status quo to be worth implementing. Perfect is the enemy of good, as they say.
Im my own radgrinder, and have not and never will be anyone else.
Merry Christmas and happy holidays to you Frumious, and that is said in the genuine spirit of the season.
Here’s how effective your $5K solution would be. A swab for $28K.
[link=https://www.npr.org/sections/health-shots/2019/12/23/787403509/for-her-head-cold-insurer-coughed-up-25-865]https://www.npr.org/secti…urer-coughed-up-25-865[/link]-
Seems all the NGO “solutions” always seem to be wanting. Christian cost-sharing health insurance doesn’t actually mean you are covered.
But then we already do know that government always fails with its “socialist” solution. What’s missing is the realization that the problem is bigger than any fantasy anti-government solutions.
[link=https://www.nytimes.com/2020/01/02/health/christian-health-care-insurance.html]https://www.nytimes.com/2…th-care-insurance.html[/link]
More than one million Americans, struggling to cope with the rising cost of health insurance, have joined such groups, attracted by prices that are far lower than the premiums for policies that must meet strict requirements, like guaranteed coverage for pre-existing conditions, established by the Affordable Care Act. The groups say they permit people of a common religious or ethical belief to share medical costs, and many were grandfathered in under the federal health care law mainly through a religious exemption.
These Christian nonprofit groups offer far lower rates because they are not classified as insurance and are under no legal obligation to pay medical claims. They generally decline to cover people with pre-existing illnesses. They can set limits on how much their members will pay, and they can legally refuse to cover treatments for specialties like mental health.
Nothing is guaranteed, said Dr. Carolyn McClanahan, a physician who is also a financial planner in Jacksonville, Fla. You have to depend on the largess of the program.
The main requirement for membership is adherence to a Christian lifestyle. And the alternative sharing plans keep flourishing, especially now that the Trump administration has relaxed rules to permit alternatives to the A.C.A. that dont provide such generous coverage.
But state regulators in New Hampshire, Colorado and Texas are beginning to question some of the ministries aggressive marketing tactics, often using call centers, and said in some cases people who joined them were misled or did not understand how little coverage they would receive if they or a family member had a catastrophic illness.
The Texas attorney general brought a lawsuit last summer against Aliera Healthcare, which marketed Trinitys ministry program, to stop it from offering unregulated insurance products to the public. [link=https://www.houstonchronicle.com/business/article/Buyer-Beware-When-religion-politics-health-14065418.php]The Houston Chronicle featured one couple who was left with more than $100,000 in unpaid medical bills[/link].
-
Seems hospitals using the cloud to store medical information are agreeing to allow said storage corporations access to your medical information and you & patients have nothing to say about it.
At least government has to get court access.
[link=https://www.wsj.com/articles/hospitals-give-tech-giants-access-to-detailed-medical-records-11579516200]https://www.wsj.com/artic…al-records-11579516200[/link]
Hospitals have granted [link=https://quotes.wsj.com/MSFT]Microsoft[/link] Corp., [link=https://quotes.wsj.com/MSFT?mod=chiclets]MSFT 0.56% [/link][link=https://quotes.wsj.com/IBM]International Business Machines [/link][link=https://quotes.wsj.com/IBM?mod=chiclets]IBM 0.24% [/link]Corp. and [link=https://quotes.wsj.com/AMZN]Amazon.com[/link] Inc. [link=https://quotes.wsj.com/AMZN?mod=chiclets]AMZN -0.70% [/link]the ability to access identifiable patient information under deals to crunch millions of health records, the latest examples of hospitals growing influence in the data economy.
This breadth of access wasnt always spelled out by hospitals and tech giants when the deals were struck.
The data belongs to whoever has it.
But recent revelations that [link=https://quotes.wsj.com/GOOG]Alphabet[/link] Inc.s [link=https://quotes.wsj.com/GOOG?mod=chiclets]GOOG 1.98% [/link][link=https://www.wsj.com/articles/google-s-secret-project-nightingale-gathers-personal-health-data-on-millions-of-americans-11573496790?mod=article_inline]Google has the ability to tap personally identifiable medical data about patients[/link], reported by The Wall Street Journal, has raised concerns among lawmakers, patients and doctors about privacy.
The Wall Street Journal also recently reported that [link=https://www.wsj.com/articles/paging-dr-google-how-the-tech-giant-is-laying-claim-to-health-data-11578719700?mod=article_inline]Google has access to more records than first disclosed in a deal with the Mayo Clinic[/link]. Mayo officials say the deal allows the Rochester, Minn., hospital system to share personal information, though it has no current plans to do so. It was not our intention to mislead the public, said Cris Ross, Mayos chief information officer.
Some hospitals are saying no to tech agreements.
Were not giving anyone data, said Jim Beinlich, chief data information officer for Penn Medicine, the University of Pennsylvania health system. Penn Medicine halted a possible research pilot with Microsoft in response to public concern over Ascensions Google deal. Hospital executives are drafting policies, such as how to tell patients about data sharing.
-
I would have greater respect for the Democratic candidates running on a Medicare for all platform if they acknowledged that such a move logically requires eliminating the medical malpractice system. This would massively bring down costs by eliminating defensive medicine, although admittedly it would take time as physicians would have to relearn how to practice medicine and think logically (e.g. if there is a 0.001% pretest probability of pulmonary embolism then dont order the CTA for PE).
Of course the reason Democratic candidates dont talk about this is that a high percentage of their donors and political colleagues make their fortunes through med-mal.
-
Quote from Frumious
At least government has to get court access.
If the FISA court is a standard, the cognitive dissonance on your part will be a sight to behold, Frumious. But that would be asking you to be honest in your assessment of things. I won’t hold my breath.
-
-
-
-
-
-
-
Quote from FriendofRad
You might appreciate Hauser’s law:
[link=https://en.wikipedia.org/wiki/Hauser%27s_law]https://en.wikipedia.org/wiki/Hauser%27s_law[/link]
Population behavior in the face of rising taxes is dynamic not static. You can’t tax your way to health and happiness for all.You trying to use Hauser’s “Law” to argue that raising tax rates on the rich doesn’t raise revenue?
“I’ve got some oceanfront property in Arizona…If you’ll buy that I’ll throw the Golden Gate in free.”-
Drad
True Obamacare did not directly try to address private insurance
(Americans would not have tolerated that at that time)
It attempted to create a better more competitive marketplace in the eventual hope that market forces would improve service choices and eventually lower costs
-
Quote from kpack123
Drad
True Obamacare did not directly try to address private insurance
(Americans would not have tolerated that at that time)
It attempted to create a better more competitive marketplace in the eventual hope that market forces would improve service choices and eventually lower costs
Americans would not tolerate the elimination of private insurance? You have been listening to too much FOX news. Private insurance sucks. Everyone knows this. It should have been eliminated decades ago.
I don’t know what competitive health market place even means in the real world. I never see it from where I stand.
Medicare has the MOST consumer choice and lowest cost! LOL Really-
Did you go into medicine to help people or to make yourself rich?
-
Quote from irfellowship2020
Did you go into medicine to help people or to make yourself rich?
Can I chose both?
-
Quote from irfellowship2020
Did you go into medicine to help people or to make yourself rich?
False dilemma, either or fallacy. Nice. Up the game por favor.
-
-
Quote from drad123
Quote from kpack123
Drad
True Obamacare did not directly try to address private insurance
(Americans would not have tolerated that at that time)
It attempted to create a better more competitive marketplace in the eventual hope that market forces would improve service choices and eventually lower costs
Americans would not tolerate the elimination of private insurance? You have been listening to too much FOX news. Private insurance sucks. Everyone knows this. It should have been eliminated decades ago.
I don’t know what competitive health market place even means in the real world. I never see it from where I stand.
Medicare has the MOST consumer choice and lowest cost! LOL Really
Want to know which insurance company has the highest percentage of claims denied? That would be Medicare. Google it.
Lots of flaws in our current system. Junking private insurance entirely would make the problems worse.-
Quote from vomer
Quote from drad123
Quote from kpack123
Drad
True Obamacare did not directly try to address private insurance
(Americans would not have tolerated that at that time)
It attempted to create a better more competitive marketplace in the eventual hope that market forces would improve service choices and eventually lower costs
Americans would not tolerate the elimination of private insurance? You have been listening to too much FOX news. Private insurance sucks. Everyone knows this. It should have been eliminated decades ago.
I don’t know what competitive health market place even means in the real world. I never see it from where I stand.
Medicare has the MOST consumer choice and lowest cost! LOL Really
Want to know which insurance company has the highest percentage of claims denied? That would be Medicare. Google it.
Lots of flaws in our current system. Junking private insurance entirely would make the problems worse.
What problems would be worse? Claim denials?
-
-
-
-
The rich will find a way around onerous taxation. But drop the rates and the economy improves, bringing in more revenue to the Treasury. Even JFK understood that, although his policies would be considered center-right today.
Punishing those who produce to pander to those who don’t has never worked in the past and it never will in the future. -
[link=https://data.oecd.org/healthres/health-spending.htm]https://data.oecd.org/healthres/health-spending.htm[/link]
It’s not about human rights ([link=https://plato.stanford.edu/entries/rights]which heathcare isn’t[/link]), it’s about building a more economically viable system and saving the country from financial collapse. If government sets rates and provides medical services for most of the population (like it does in Canada, Australia, Western Europe, Israel, Singapore, etc), it will reduce reimbursements for most services and get rid of unnecessary bureaucratic expenses in the middle, reducing the total system cost. There can still be private insurance and private clinic options for a small subset of rich people (again, like in Canada, Australia, Israel, etc), most people won’t choose it due to the high price. It works elsewhere and it’s proper capitalism (as opposed to banning private insurance and promising no deductibles by Bernie who’s not aware of moral hazard and other basic insurance concepts).
Sure, some insurance and hospital paper pushers will lose their jobs, European pharma will lose their primary revenue source, and the US doctor salaries will be cut in half (to match other wealthy countries), but everybody else in the US will benefit. There can be a transition period in the law to minimize the shock and give leeches time to repurpose their skills. And if we’re smart we should also reform medical liability, licensing, and education as part of the package so that doctors don’t have to buy malpractice insurance, go in massive debt, or waste 10 years studying for something a midlevel can do. Again, these concepts aren’t new and they work elsewhere.-
Which of the systems you cited are the choices of those who can afford to go anywhere in the world? NONE of them. Such people go to the United States for the finest care. The results from the English NHS in particular are nothing to be proud of.
You guys have convinced yourselves that poor medicine for all is somehow noble.-
Quote from DoctorDalai
Which of the systems you cited are the choices of those who can afford to go anywhere in the world? NONE of them. Such people go to the United States for the finest care. The results from the English NHS in particular are nothing to be proud of.
You guys have convinced yourselves that poor medicine for all is somehow noble.
Correctimundo.
[link=https://www.theguardian.com/society/2019/jul/19/nhs-cancer-scans-unread-pension-row]https://www.theguardian.c…ans-unread-pension-row[/link]
Show me any American who would tolerate this kind of care.
I don’t know a lot of the details, but the Swiss system seems to work pretty well. Obamacare on steroids – the penalties for not carrying insurance are high. Thus, almost all of the healthy folks pay for it. insurance companies make enough revenue to pay doctors/hospitals well, in addition to providing excellent coverage.-
If physicians would stick together we could guide the discussion
Unfortunately we are so divided politically that we get played by the hospital interests, device makers, big pharma and most of all insurance conglomerates
Who do you think wins all the time…….,., insurance companies and usually hospitals
-
Who are you supporting in the debates? sounds to me like most of you aren’t very progressive, maybe Biden and Harris supporters, not bernie and warren supporters.
-
Irfellow is not an ir fellow. Trolling imo
-
This is a shared account used by residents starting IR Fellowship in 2020. It does not belong to one person. It seems like some users didn’t want to go through the effort of creating therir own auntminnie account after the IR application process was over.
[link=https://www.auntminnie.com/forum/tm.aspx?m=562097]https://www.auntminnie.com/forum/tm.aspx?m=562097[/link]
-
-
-
-
Quote from DoctorDalai
Which of the systems you cited are the choices of those who can afford to go anywhere in the world? NONE of them. Such people go to the United States for the finest care. The results from the English NHS in particular are nothing to be proud of.
You guys have convinced yourselves that poor medicine for all is somehow noble.
American exceptionalism- shades of a Trump supporter.
I have met many great docs from other countries- America doesn’t have a monopoly on intelligence.
-
-
“Sure, some insurance and hospital paper pushers will lose their jobs, European pharma will lose their primary revenue source, and the US doctor salaries will be cut in half (to match other wealthy countries), but everybody else in the US will benefit. There can be a transition period in the law to minimize the shock and give leeches time to repurpose their skills. And if we’re smart we should also reform medical liability, licensing, and education as part of the package so that doctors don’t have to buy malpractice insurance, go in massive debt, or waste 10 years studying for something a midlevel can do. Again, these concepts aren’t new and they work elsewhere. ”
How will your favorite uber leech Rad Partners repurpose its skills? Skimming from the drastically reduced radiologist reimbursements or replacing them with midlevels. LOL-
When I see a system that finally does something to HELP physicians (post grandfathered physicians) in some way, after degradation year after year under the current paradigm, I’ll pay attention.
Without addressing the unsustainable physician problem (greater debts at crazy interest, lesser payments, more qualifications and hoops to jump through), none of this gets anywhere.
-
-
-
“You trying to use Hauser’s “Law” to argue that raising tax rates on the rich doesn’t raise revenue?”
No, I am only pointing to the fact that 70% plus marginal income tax rates in US didn’t appreciably increase tax to GDP ratio. Going to back to those rates will likely have similar disappointing effects. Sure in short term tax collection will increase, before the wealthy adjust. Let’s say the increase is 5% of GDP, with the current trends in medicare inflation, it will be consumed in a jiffy. The answer is to bend the cost curve. All means of doing it will be extremely painful to at least someone, as 20% of economy is healthcare. Politics will determine who bears the pain. If pain is disproportionately distributed to physicians, it will destroy the healthcare quality decades into future. -
“Highest attainable standard”
Right, who could ever argue about that? LOL
These clowns are really insulting, they think we are as dense as they are. -
In Australia people are on the whole happy with the health care quality. Medicare for all is an integral part of that. As it happens, there is essentially no reimbursement for diagnostic imaging from non-Medicare sources, that’s just a quirk in the system.
-
If states all legalized physician assisted suicide and medicare starts pushing patients to choose it as an option, it would probably lead to major savings. A huge portion of healthcare costs come at end of life. It might not be ethical, but if families shared in the cost savings for choosing assisted suicide, they’d probably be even more inclined to choose the option.
-
“A Modest Proposal” by Jonathan Swift comes to mind…
Satire always contains an element of truth.
-
This is getting scary.
-
-
-
Not fun to talk about but would save so much money
-
What about lifetime caps? Welfare in exchange for agreement never to have children (that use state resources)? There are a lot of perverse incentives in freebie world.
-
Why are we interested in spending so much money on healthcare to lengthen human lives? The earth and environment and climate would be better off if humans went extinct sooner rather than later. At the very least we should allocate this money on planting trees or promoting contraception and abortions in poor countries. Wouldnt that be the long term responsible thing to do?
-
This sounds like the awesome (presumed) plant at the AOC rally that talked about eating human babies.
If you aren’t kidding, we are in a sad, sad state. The manipulation of the modern mind is amazing.-
If you look at what human beings are closest too, it would be a virus. We move to new places and reproduce uncontrollably, destroying the environment. We caused many species to go extinct. We should use our money to repay the environment rather than extend human lives even further with costly and wasteful healthcare. The earth is heating up to try to get rid of us like the human body does with a viral infection. We are not welcome here. We think were so noble as radiologists saving human lives, but are we really doing good?
-
When was the last time the US govt did anything correctly? Why do people want more control, particularly decisions on their own health, given to the US govt? The best thing the US govt does is collect taxes and run a military and they’re not even that good at that either. The solution to all the problems isn’t even on the table and never will be.
-
Nonsensical hyperbole.
-
277 far more accurate than 276.
Of course, a “boomer” would fulfill stereotypes. -
Quote from irfellowship2020
If you look at what human beings are closest too, it would be a virus. We move to new places and reproduce uncontrollably, destroying the environment. We caused many species to go extinct. We should use our money to repay the environment rather than extend human lives even further with costly and wasteful healthcare. The earth is heating up to try to get rid of us like the human body does with a viral infection. We are not welcome here. We think were so noble as radiologists saving human lives, but are we really doing good?
1. Human beings are living and autonomous, inasmuch as that is a biological definition, so they are unlike viruses. So the first statement is inaccurate.
“We move to new places and reproduce uncontrollably, destroying the environment.” No we don’t.
“We caused many species to go extinct.” Not compared to history and “mother nature” with her climate change, or asteroids, or volcanoes. Just ask the Dinosaurs. Oh yeah, they can’t blame humans. I wonder why.
Extending human lives can be an idol, I can agree with you on this, but it’s an entirely different point.
“The earth is heating up to try to get rid of us like the human body does with a viral infection. We are not welcome here.”
The earth is not heating in any meaningful way, and certainly not trying to get rid of us. If that were the case, it has done it thousands of times before, so this time would be no different, and all of this would just be “natural” in the first place.
Your last question betrays your thinking. What is good? Your view, I’m guessing, is one that can’t appeal to any authority, or any particular authority that matters. In your view, you have disdain at the dominating power of humans, apparently. Why be mad at humans? Be mad at the “earth” that gave rise to us, but that you now say is trying to get rid of us. LOL, the circular logic is amazing for the postmodernist, who can’t appeal to anything, and if she does, it becomes even more nonsensical.
It is the extreme irony that someone who complains about human systems will try to use human thinking and human systems to negate or rectify the verify human “problems” he claims are happening because of … humans.
-
-
-
-
-
-
[b]Supreme Court Upholds Obamacare Again[/b][/h1]
The Supreme Court upheld the Affordable Care Act for the third time, saying Texas and the individual plaintiffs challenging it cant prove they were harmed by the individual mandates zero penalty, the [link=https://www.washingtonpost.com/politics/courts_law/affordable-care-act-survives-third-supreme-court-challenge-as-case-from-trump-administration-and-gop-led-states-is-rejected/2021/06/17/1d800dce-cf6f-11eb-8cd2-4e95230cfac2_story.html?wpmk=1&wpisrc=al_news__alert-politics–alert-national&utm_source=alert&utm_medium=email&utm_campaign=wp_news_alert_revere&location=alert&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.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.P4-MIBnNPl2Q2rFPJ8pc5hPYzSej1wQTopb3cN538sg]Washington Post[/link] reports.
The [link=https://www.supremecourt.gov/opinions/20pdf/19-840_6jfm.pdf]decision was 7 to 2[/link], with Justice Stephen Breyer writing for the majority and Justices Samuel Alito and Neil Gorsuch dissenting.-
Healthcare is not a right. It’s a service. Services are never guaranteed.
-
-
Actor William Holden, who could have worked on many movie roles a year, turned down the extra work to avoid moving into a higher tax bracket. Once rates are above 50% total, you are no longer working for yourself. You are the civil servant, or should I say the civil subservient.
So what if a small business owner made enough money in the first half of the year, such that he hit the threshold for a 70% tax bracket. He would likely close up shop, lay off all his workers, and head to his summer home for an extended vacation. The feds don’t collect a penny of the higher tax RATE, and then get zero dollars of taxes from any of his employees from July thru December. So yes, total net income tax collected goes down if the rates go up. Remember, the richest that you claim can “afford” to pay a little more, can also afford to stop working for half or more of a year too.
If you want to raise total revenue, go to a flat tax rate with zero exemptions and a mandatory balanced federal budget each year. Those who make less, pay less, those who make more pay more, but the rate is based on what the government wants to spend. If you want Medicare for ALL, then the new tax rate for ALL has to go up. It will affect ALL the voters. You will quickly see that a lot of these “rights” turn out to be not so important after all.-
Quote from dxaguru
Actor William Holden, who could have worked on many movie roles a year, turned down the extra work to avoid moving into a higher tax bracket. Once rates are above 50% total, you are no longer working for yourself. You are the civil servant, or should I say the civil subservient.
So what if a small business owner made enough money in the first half of the year, such that he hit the threshold for a 70% tax bracket. He would likely close up shop, lay off all his workers, and head to his summer home for an extended vacation. The feds don’t collect a penny of the higher tax RATE, and then get zero dollars of taxes from any of his employees from July thru December. So yes, total net income tax collected goes down if the rates go up. Remember, the richest that you claim can “afford” to pay a little more, can also afford to stop working for half or more of a year too.
If you want to raise total revenue, go to a flat tax rate with zero exemptions and a mandatory balanced federal budget each year. Those who make less, pay less, those who make more pay more, but the rate is based on what the government wants to spend. If you want Medicare for ALL, then the new tax rate for ALL has to go up. It will affect ALL the voters. You will quickly see that a lot of these “rights” turn out to be not so important after all.Not many businesses can be turned off half the year and stay profitable.
Not many employees can only work half a year and make ends meet.
Not many business bros can afford a second home when taxed at a 70% rate.
You should really think through right wing propaganda before believing and then posting. -
Um, do you have a link for that factoid about William Holden because I’ve only heard of something like this as a possibility, an urban myth, never an actual fact. When did it happen? Because until 1982, we had a 70% tax bracket & I had never heard of anyone, actor, businessman or millionaire, etc ever turning down work/income or closing shop or business due to moving up to the next tax bracket. In fact the 70% bracket existed since 1936 to 1982; in fact in 1944 the top bracket went up to 94% & in 1946 it declined to 91% until 1964 when it decreased to 74% under Kennedy.
[link=https://taxfoundation.org/historical-income-tax-rates-brackets/]https://taxfoundation.org/historical-income-tax-rates-brackets/[/link]
In the 1950’s our economy exploded.
Further, there has been many multiple tax brackets since federal taxes were introduced. income taxes, not just 2 or 3 or 5.
Further, in 1957, Holden was the 1st actor to be paid $1 million for a single role on Bridge on the River Kwai. 1957 is well within the 70% tax bracket period with the top bracket being 91% for earnings over $400k
Holden had his most widely recognized role as “Commander” Shears in [link=https://en.wikipedia.org/wiki/David_Lean]David Lean[/link]’s [i][link=https://en.wikipedia.org/wiki/The_Bridge_on_the_River_Kwai]The Bridge on the River Kwai[/link][/i] (1957) with [link=https://en.wikipedia.org/wiki/Alec_Guinness]Alec Guinness[/link],[link=https://en.wikipedia.org/wiki/William_Holden#cite_note-24][24][/link] a huge commercial success. His deal was considered one of the best ever for an actor at the time, with him receiving 10% of the gross, which earned him over $2.5 million.
He initially stipulated to receive only $50k per year but when the movie became a hit and interest on unpaid profits grew larger than the payments, he settled for a $1 million lump payment.
I know of no time Holden not working due to fear of tax brackets.
Please provide information.
-
Quote from dxaguru
If you want Medicare for ALL, then the new tax rate for ALL has to go up. It will affect ALL the voters. You will quickly see that a lot of these “rights” turn out to be not so important after all.
Ya, healthcare when you need it isn’t important. Most people wouldn’t want it. Do you have any experience with healthcare?
When people need it they do want it. And almost everyone will need it at some point.
-
[link=https://www.axios.com/2022/11/10/republicans-elections-house-health-congress?utm_medium=social&utm_campaign=editorial&utm_source=twitter]https://www.axios.com/202…amp;utm_source=twitter[/link]
Little summary article.
Bottom lines:
Republicans have no healthcare agenda this cycle for the first time since the passage of the ACA and will likely try to ignore the issue going in to 2024.
Inflation is going to hit, especially if hospitals successful negotiate higher payments with insurers … get ready for big premium hikes.
If/when the Covid emergency gets cancelled, lots of people will get kicked off of Medicaid and the uninsured rate will spike.
-
Quote from drad123
Quote from dxaguru
If you want Medicare for ALL, then the new tax rate for ALL has to go up. It will affect ALL the voters. You will quickly see that a lot of these “rights” turn out to be not so important after all.
Ya, healthcare when you need it isn’t important. Most people wouldn’t want it. Do you have any experience with healthcare?
When people need it they do want it. And almost everyone will need it at some point.
both can be true
“tax the rich” is a political winner in the US; but any attempt to broadly raise taxes to ~ EU levels on those making < $200k/year would be political suicide. And yet, that’s what it would take to get an EU level safety net.
Yes I know there are convoluted proposals to get around this, but I doubt they ever happen.-
None of that would ever happen overnight if at all. It’s too similar to the argument why renewables & reducing fossil fuel levels would bankrupt the country. The reality is much more optimistic than end of civilization arguments.
The problem is not taxing everyone to European levels providing the same level of safety nets, the problem is our highest cost in the whole world of medical care denying care for very many Americans while providing a thin safety net for many and none at all for many others.
There is a very lot of room for improvement before we even approach European levels of taxation for social reasons. It is not a zero-sum solution any more than addressing renewable energy is.
-
The current Medicare system would work pretty well if limits were placed on use rather than payments to physicians.
I know, the dread “rationing’ word. The reality is, any system that provides free health care to its citizens must use a form of rationing, not matter how much the population is taxed.
-
So your argument is Medicare is overused as the reason for expense, not the cost of healthcare & charges by providers & pharm.
Where is your data to make that claim?
Because as Ive read all the data, all the free access in all the other parts of the world is still both less expensive than the USs not free Medicare AND their use is not higher.
If you say it is, show the data.
You cant make empty claims like that.
And retirees in US still pay for their Medicare so where exactly is it free? You & your family do not fully pay for your own healthcare insurance & use, it is supported by all taxpayers.
-
My argument is where health care is free it is limited in access for the expensive items. You dont just roll into a hospital in Europe and get a CTA of every body part when you have a ground level fall like you do in our hospital. You dont get the type of crazy expensive stroke programs that you see here. You dont see people over 80 in ICUs that never leave and and rack up millions in Medicare costs.
You dont control the cost of something by saying it can only cost so much per unit.
If we give it away, which honestly I think we should, we need to make sure there are limits on how it is utilized. Free trauma surgery coverage? Check. Free basic antibiotics and chemotherapy? Check.
Free newest and greatest medications and medical devices that arent proven to work any better than the old ones? Not so much.
-
Why cant we get there? Because the Dems that could give it to us are afraid to admit it would require saying no to some things.
-
-
-
-
-
Quote from dxaguru
If you want to raise total revenue, go to a flat tax rate with zero exemptions and a mandatory balanced federal budget each year. Those who make less, pay less, those who make more pay more, but the rate is based on what the government wants to spend. If you want Medicare for ALL, then the new tax rate for ALL has to go up. It will affect ALL the voters. You will quickly see that a lot of these “rights” turn out to be not so important after all.
Annual [u]mandatory[/u] balanced budget?
Have you actually thought that out? For example funding entirely emergency spending like hurricane relief for Florida & Texas & Mississippi & Alabama by next years tax increases? How about the Iraq & Afghanistan wars? Fully paid for with tax increases in the next year?
Yes, Im very sure taxpayers would kick.
Lets consider that solution for everyone. No more deficit spending for households or businesses. No more loans. Everything will be like American Express, you pay in full each month for what you borrowed. Businesses would have to raise prices to pay for spending.
The stock markets? Banks? Would be interesting. Talk about killing the economy.
Yes, I am very sure consumers & taxpayers would not be impressed by the brag of a mandatory balanced budget.There is a reason global investors & nations look to America for leadership. It has nothing to do with mandatory balanced budgets.
-
-
-
-
-
-
And Obamacare got kneecapped by insurance companies and political opportunism
Now we are in a more drastic debate
-
Quote from irfellowship2020
Did you go into medicine to help people or to make yourself rich?
This is a statement that I have not heard from anybody beyond third year of medical school. -
The Dems in these debates come across as extremely liberal… bordering on nut jobs. I am not sure what internal research the Dems have done telling them this is what people want, but I think it is an easy victory for Trump in 2020 with this joke of a field.
-
Quote from Waduh Dong
The Dems in these debates come across as extremely liberal… bordering on nut jobs. I am not sure what internal research the Dems have done telling them this is what people want, but I think it is an easy victory for Trump in 2020 with this joke of a field.
Actually… the polling on what people wants hits closest to Biden’s plan.
People want the ACA to be supported. They want a public option…. to be able to opt-in to Medicare if they want to.
They want help with co-pays and deductible.
They do [b]not[/b] want to abolish employer-sponsored health insurance.
[link=http://maristpoll.marist.edu/wp-content/uploads/2019/07/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_1907190926.pdf#page=3]http://maristpoll.marist.edu/wp-content/uploads/2019/07/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_1907190926.pdf#page=3[/link]
[link=https://fivethirtyeight.com/features/medicare-for-all-isnt-that-popular-even-among-democrats/]https://fivethirtyeight.com/features/medicare-for-all-isnt-that-popular-even-among-democrats/[/link]
-
Chronological snobbery is an argument that the thinking, art, or science of an earlier time is inherently inferior to that of the present, simply by virtue of its temporal priority or the belief that since civilization has advanced in certain areas, people of earlier periods were less intelligent.
-
I have resisted posting here, in large part because I find the way politicians (and by extension – their true believers) treat these vastly complex topics to be hopelessly superficial.
And “medicare for all” is perhaps the best example. Three words. really?
here is an article that, if I ruled the world, I would require everyone to read before making any further comments, and I would require, before commenting, that each person must suggest a way to pay for this treatment. Beyond that – this is just the first in a promised endless stream of treatments that will, because of their sophistication, require ever increasing expenditures.
[link=https://jamanetwork.com/journals/jama/fullarticle/2744409?guestAccessKey=cf879e08-fb93-441c-a8e7-b64c407e7f69&utm_content=weekly_highlights&utm_term=080319&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email]https://jamanetwork.com/j…1&utm_medium=email[/link]
The treatment – CART for B-cell lymphomas, is effective, and unquestionably saves lives. Cost starts at $475,000 for the treatment alone, exclusive of any hospitalizations that might be required.
This is a small number of patients.
The point here is that at some point, the resources we must expend to give the most advanced, most sophisticated treatments will, without any question, exceed the GNP of the country. What then?
Do we 1) stop inventing these treatments altogether? 2) decide who gets the expensive treatments, either by (death) committee or de facto – as a result of their ability to pay (Steve Jobs got a liver transplant that he probably should not have). 3) Some other solution that I cannot think of. Perhaps you can.-
Quote from Dr.Sardonicus
I have resisted posting here, in large part because I find the way politicians (and by extension – their true believers) treat these vastly complex topics to be hopelessly superficial.
And “medicare for all” is perhaps the best example. Three words. really?here is an article that, if I ruled the world, I would require everyone to read before making any further comments, and I would require, before commenting, that each person must suggest a way to pay for this treatment. Beyond that – this is just the first in a promised endless stream of treatments that will, because of their sophistication, require ever increasing expenditures.
[link=https://jamanetwork.com/journals/jama/fullarticle/2744409?guestAccessKey=cf879e08-fb93-441c-a8e7-b64c407e7f69&utm_content=weekly_highlights&utm_term=080319&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email]https://jamanetwork.com/j…1&utm_medium=email[/link]
The treatment – CART for B-cell lymphomas, is effective, and unquestionably saves lives. Cost starts at $475,000 for the treatment alone, exclusive of any hospitalizations that might be required.
This is a small number of patients.
The point here is that at some point, the resources we must expend to give the most advanced, most sophisticated treatments will, without any question, exceed the GNP of the country. What then?
Do we 1) stop inventing these treatments altogether? 2) decide who gets the expensive treatments, either by (death) committee or de facto – as a result of their ability to pay (Steve Jobs got a liver transplant that he probably should not have). 3) Some other solution that I cannot think of. Perhaps you can.Point well taken-
No third party seems to be able to draw the line- Medicare, Medicaid, or commercial insurance. This is really a separate issue.
Having commercial insurance companies will not decrease costs but will in fact increase them as it has.-
Ok, America is an amazing country. With many problems, like any human endeavor. But still, astonishingly amazing.
Call me when Canada lands on the moon.
-
Quote from radgrinder
Ok, America is an amazing country. With many problems, like any human endeavor. But still, astonishingly amazing.
Call me when Canada lands on the moon.
Yeah – I have a problem when people start harping on American Exceptionalism. Its as if they have to find a way to punish themselves. As if they feel some guilt because they live in a great place.
And – really – America IS exceptional. No question.
It’s like Floridians feeling guilty that it is nice there in the winter. WHAT??
-
Do you realize had we not gone to war we would be much like Canada and Australia sans the needless deaths rendered by the American Revolutionary War?
Say what? Thats amazing.
-
meh, foreign wealthy are coming to United States much less often. Talk to anybody at Mayo, Weill Cornell, or the typical players, their income from foreign wealth has gone down substantially because those patients now have resources locally.
this whole thread was a troll trap from the start
-
-
Quote from Dr.Sardonicus
Quote from radgrinder
Ok, America is an amazing country. With many problems, like any human endeavor. But still, astonishingly amazing.
Call me when Canada lands on the moon.
Yeah – I have a problem when people start harping on American Exceptionalism. Its as if they have to find a way to punish themselves. As if they feel some guilt because they live in a great place.
And – really – America IS exceptional. No question.
It’s like Floridians feeling guilty that it is nice there in the winter. WHAT??
Many nation-states have risen to power and fallen throughout history- this is the way of the world- you know this.
O Fortuna
velut luna
statu variabilis,
semper crescis
aut decrescis;
vita detestabilis
nunc obdurat
et tunc curat
ludo mentis aciem,
egestatem,
potestatem
dissolvit ut glaciem.
O Fortune,
like the moon
you are changeable,
ever waxing
ever waning;
hateful life
first oppresses
and then soothes
playing with mental clarity;
poverty
and power
it melts them like ice.-
Well yeah, very erudite. But thats Latin. And the nation/empire that used that language was pretty exceptional in itself, with myriad accomplishments in governance, architecture, commerce and overall raising the quality of life of people in that time. Lot of problems sure, but everyone wanted to be a Roman citizen. And people still use their language today.
So…the poem indicates that Fortune causes things to rise and fall, but the language its written in indicates that truly exceptional nation states can have a lasting and positive influence thousands of years after they have become something else. And the citizens of those nations wouldnt have traded places with anyone else at the time.
So….winner? 🙂
-
-
-
-
-
-
Quote from Galatian
Chronological snobbery is an argument that the thinking, art, or science of an earlier time is inherently inferior to that of the present, simply by virtue of its temporal priority or the belief that since civilization has advanced in certain areas, people of earlier periods were less intelligent.
Yes, as I’ve described above, not only is it the most thoughtless and indoctrinated of behaviors it is the most [i][b]dishonest [/b][/i]way of thinking and living one can possibly imagine. The snobbery alone is the very evidence that “progress” is a fiction in near all considerations. What’s the point of technological progress when your spirit and manner of thinking is totally regressive?
-
-
Quote from dergon
Quote from Waduh Dong
The Dems in these debates come across as extremely liberal… bordering on nut jobs. I am not sure what internal research the Dems have done telling them this is what people want, but I think it is an easy victory for Trump in 2020 with this joke of a field.
Actually… the polling on what people wants hits closest to Biden’s plan.
People want the ACA to be supported. They want a public option…. to be able to opt-in to Medicare if they want to.
They want help with co-pays and deductible.
They do [b]not[/b] want to abolish employer-sponsored health insurance.
[link=http://maristpoll.marist.edu/wp-content/uploads/2019/07/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_1907190926.pdf#page=3]http://maristpoll.marist.edu/wp-content/uploads/2019/07/NPR_PBS-NewsHour_Marist-Poll_USA-NOS-and-Tables_1907190926.pdf#page=3[/link]
[link=https://fivethirtyeight.com/features/medicare-for-all-isnt-that-popular-even-among-democrats/]https://fivethirtyeight.com/features/medicare-for-all-isnt-that-popular-even-among-democrats/[/link]
Wrong- they do not want to abolish the [b]employer contribution [/b]to health coverage.
A Medicare option cannot exist. How can a for profit commercial insurance company compete with a not for profit which has negotiated lower rates than any commercial insurance company? There would be constant gaming between the two as well.
keep drinking the Kool-Aid….-
Counsel about a false binary here. The choice is not between no health care for the elderly vs Medicare for All.
It is a very rare thing where the best solution to a problem is have the government handle it. That usually makes the problem worse.
-
Quote from radgrinder
Counsel about a false binary here. The choice is not between no health care for the elderly vs Medicare for All.
It is a very rare thing where the best solution to a problem is have the government handle it. That usually makes the problem worse.
On the contrary, our private insurance system is a total mess, the most expensive in the world with varying excuses to deny coverage, specifically especially before the ACA and inefficient. What is the employment for coders in hospitals and private practices and insurance companies? Rather large. And why should that be? Well profits are a very good reason for such with practices and hospitals using coders to extract the maximum reimbursement and insurance companies using coders to keep profits high for shareholders. This adds a great deal to the overhead administrative cost of American healthcare.
Gubmint Medicare is an example of efficiency by comparison costing much less than the private enterprises. All teh data I’ve seen over a couple of decades supports this idea that government is more efficient while private for-profit is much more costly and inefficient.
You don’t have to like government but 2 things, in the absence of government there is no system, examples abound – and government is not in the business of profiteering so by definition you get more bang for the buck all things being equal.
Without government Medicare there is no general care for the elderly unless the person or family is already affluent.
That is the false binary. Yes, the family should be responsible but it’s a big but that flattens all circumstances to the same level field contrary to reality. Is the family capable of all and every situation? And then there is the issue of cost and affordability.
-
Quote from Frumious
What is the employment for coders in hospitals and private practices and insurance companies? Rather large. And why should that be? Well profits are a very good reason for such with practices and hospitals using coders to extract the maximum reimbursement and insurance companies using coders to keep profits high for shareholders. This adds a great deal to the overhead administrative cost of American healthcare.The coding game will still exist in a Medicare for all world. Just won’t collect 300% of Medicare for the codes.
-
-
-
-
-
-
Quote from deadwing
I, too, feel that a few dozen white supremacist slave owners that lived prior to electricity are infallible and should have any say whatsoever in how we should run our government or society.
What does them living prior to electricity have to do with them being right or wrong?
Not all were slave owners. And few, if any, were white supremacists.
Point is, America became what it is based on the principles adopted by those guys. I’m not one to say “if you don’t like America, leave” but if you think they are morally bankrupt I’m truly puzzled why you would feel comfortable profiting as a radiologist in the system you work in.-
What are you even talking about? Who gives a sh*t what they thought? Theres no way to know. Theyve been dead for hundreds of years and the constitution only means whatever 5 of 9 say it means. What a silly argument.
-
Quote from deadwing
What are you even talking about? Who gives a sh*t what they thought? Theres no way to know. Theyve been dead for hundreds of years and the constitution only means whatever 5 of 9 say it means. What a silly argument.
Well…when a group of guys creates a system of government that gives a robust political structure to the greatest nation that the world has ever seen, and then in the first couple hundred years of that nation’s short lifetime it gives birth to a ridiculous amount of advancements in nearly every field known to man, powers the world economy and lifts billions out of poverty and disease…yeah, I’ll spend a few seconds on Google seeing if I can figure out how those guys thought. They did write a lot of things explaining their thought processes.
Here you go: [link=http://www.let.rug.nl/usa/documents/1786-1800/the-federalist-papers/]http://www.let.rug.nl/usa/documents/1786-1800/the-federalist-papers/[/link]
-
On the topic of the value of the constitution and federalists.
Democracy of the dead…
Chesterton wrote in Orthodoxy how we tend to forget and undervalue brilliance from history, assuming recent knowledge trumps the past.
Tradition means giving a vote to most obscure of all classes, our ancestors. It is the democracy of the dead.
Tradition refuses to submit to the small and arrogant oligarchy of those who merely happen to be walking about. All democrats object to men being disqualified by the accident of birth; tradition objects to their being disqualified by the accident of death.
So James Monroe, Ovid, Aristotle et al earned their due.
-
Quote from radgrinder
Well…when a group of guys creates a system of government that gives a robust political structure to the greatest nation that the world has ever seen, and then in the first couple hundred years of that nation’s short lifetime it gives birth to a ridiculous amount of advancements in nearly every field known to man, powers the world economy and lifts billions out of poverty and disease…yeah, I’ll spend a few seconds on Google seeing if I can figure out how those guys thought. They did write a lot of things explaining their thought processes.Again, American exceptionalism-
Do you realize had we not gone to war we would be much like Canada and Australia sans the needless deaths rendered by the American Revolutionary War?
-
Quote from drad123
Quote from radgrinder
Well…when a group of guys creates a system of government that gives a robust political structure to the greatest nation that the world has ever seen, and then in the first couple hundred years of that nation’s short lifetime it gives birth to a ridiculous amount of advancements in nearly every field known to man, powers the world economy and lifts billions out of poverty and disease…yeah, I’ll spend a few seconds on Google seeing if I can figure out how those guys thought. They did write a lot of things explaining their thought processes.Again, American exceptionalism-
Do you realize had we not gone to war we would be much like Canada and Australia sans the needless deaths rendered by the American Revolutionary War?
yeah, we should have picked the model of the French Revolution. That was really peaceful and death free. Or maybe Ireland. that was accomplished with zero bloodshed.
Seems like much of your derision of our health care system is driven by dislike of the status quo (with a healthy dose of hatred of Republicans). I’m a squishy moderate, but I don’t think it’s pro Trump to point out the very valuable aspect of our health care system (rapid care, higher cancer cure rates than most of the world), and wish to not “throw the baby out with the bathwater”. There are lots of examples of other systems failing in those regards. NHS and Canada among them.
-
Quote from vomer
Quote from drad123
Again, American exceptionalism-
Do you realize had we not gone to war we would be much like Canada and Australia sans the needless deaths rendered by the American Revolutionary War?yeah, we should have picked the model of the French Revolution. That was really peaceful and death free. Or maybe Ireland. that was accomplished with zero bloodshed.
Seems like much of your derision of our health care system is driven by dislike of the status quo (with a healthy dose of hatred of Republicans). I’m a squishy moderate, but I don’t think it’s pro Trump to point out the very valuable aspect of our health care system (rapid care, higher cancer cure rates than most of the world), and wish to not “throw the baby out with the bathwater”. There are lots of examples of other systems failing in those regards. NHS and Canada among them.
The American Revolution was modeled after the French Revolution- hence the bloodshed.
Higher cancer cure rates than most of the world is an extremely complex statement fraught with many unknown variables- lead time bias anyone?-
Perhaps you should google when the French Revolution occurred.
-
Also, pursuing change within the confines of our representative democracy is the exact opposite of forcing something that nobody wants. Again, absurd arguments.
Anyway whatever. Our current system will keep stumbling forward until we get horrible Medicaid (as distinguished from Medicare) for all or a nationwide VA system. Or worse. Just keep your head in the sand.
-
Quote from deadwing
Also, pursuing change within the confines of our representative democracy is the exact opposite of forcing something that nobody wants. Again, absurd arguments.
Anyway whatever. Our current system will keep stumbling forward until we get horrible Medicaid (as distinguished from Medicare) for all or a nationwide VA system. Or worse. Just keep your head in the sand.
Whoever said it would be forcing something that “nobody wants”? I can’t seem to find that mentioned anywhere here. What I personally don’t want to see is a very vocal minority group trying to push whatever they think is right onto the majority. I think the rally cries for change to our healthcare are coming more from a very vocal minority than the majority. Most of us Americans (over 50%) are happy with quality, coverage, and price. Just because some people complain and go out of their way to make everyone know doesn’t mean most people feel that way.
-
-
-
Quote from drad123
The American Revolution was modeled after the French Revolution- hence the bloodshed.
Astounding.
-
A person much wiser than I said that one should try not to make enemies. Its OK to disagree with someone. Everyone expects that from time to time, and reasonable people can debate differing perspectives on an issue and come to a better understanding or solution.
Its when one attributes the opposing partys view to them being a right or left winger, or this or that demographic, that things break down. It means that one has stopped treating the other party as an individual capable of their own thoughts and conclusions and treats them as merely the product of whatever ideology or demographic one has associated them with. Its dehumanizing, lazy, unnecessary and counterproductive. Its why Hillarys deplorables comment carried such heft: it confirmed the sensation that she thought the people who disagreed with her were below her.
As far as Medicare for All goes…Id prefer to start from the ground up regarding what we should pay for and break it into smaller bills.
Bill 1: should everyone be guaranteed emergent care for life threatening situations (car wreck, heart attack, stroke)? Pretty sure most people vote yes.
Bill 15: should people be guaranteed care for more chronic things (diabetes, hypertension, cholesterol)? An interesting argument here. I think providing generic meds would ultimately save money and lives.
Bill 3,457: should everyone be guaranteed Botox injections for their wrinkles? This is less likely to pass than the emergent care one.
-
Even if the government provided coverage for Botox I doubt youd find a dermatologist who would take the insurance!
-
It depends upon the reimbursement amount, speed of payment, denial rate and amount of red tape associated with filling a claim.
-
-
-
Dr. Sardon, I see you know that 1789 came after 1776.
The American Revolution was a continuation of the English Civil War. Discuss. Coffee talk.
I would like to recommend to all, Priced Out by Uwe Rheinhardt, posthumous publication. 4 hrs Audible, 2 hours speed read, or 30 minutes skimming the graphs. Forwards by polar opposites with a Princeton pedigree–Krugman and Frist.
-
-
-
-
-
-
-
Vomer – you’re wasting you’re time. Anyone who posts that level of both anger [self-explanatory] and intellectual laziness [never heard of the Federalist Papers?] has his/her opinion and certainty of it already decided.
-
-
Quote from Dr.Sardonicus
I have resisted posting here, in large part because I find the way politicians (and by extension – their true believers) treat these vastly complex topics to be hopelessly superficial.
And “medicare for all” is perhaps the best example. Three words. really?here is an article that, if I ruled the world, I would require everyone to read before making any further comments, and I would require, before commenting, that each person must suggest a way to pay for this treatment. Beyond that – this is just the first in a promised endless stream of treatments that will, because of their sophistication, require ever increasing expenditures.
[link=https://jamanetwork.com/journals/jama/fullarticle/2744409?guestAccessKey=cf879e08-fb93-441c-a8e7-b64c407e7f69&utm_content=weekly_highlights&utm_term=080319&utm_source=silverchair&utm_campaign=jama_network&cmp=1&utm_medium=email]https://jamanetwork.com/j…1&utm_medium=email[/link]
The treatment – CART for B-cell lymphomas, is effective, and unquestionably saves lives. Cost starts at $475,000 for the treatment alone, exclusive of any hospitalizations that might be required.
This is a small number of patients.
The point here is that at some point, the resources we must expend to give the most advanced, most sophisticated treatments will, without any question, exceed the GNP of the country. What then?
Do we 1) stop inventing these treatments altogether? 2) decide who gets the expensive treatments, either by (death) committee or de facto – as a result of their ability to pay (Steve Jobs got a liver transplant that he probably should not have). 3) Some other solution that I cannot think of. Perhaps you can.
When you really consider the “bang for your buck” of these cancer therapies, it’s almost laughable given the “cost”. I am slackjawed at colleagues who think extending a person’s life with stage 4 disease from 1 month to 3 months is an achievement (of course, given the cost, which they never talk about). I think even giving a person 1-2 years extra with cancer is fool’s errand, given the cost. If costs could truly go down for everyone 20x and we basically shut down the pharmacopeia, I’d be all for it, just in full disclosure. People in interested in living a healthy lifestyle barely need this kind of excess healthcare at this point, and the goalposts keep moving. It’s not a tragedy to die in your late 60s, sorry, that’s what happened to most people in the history of the world, or worse. I say that mostly because this game of healthcare costs has been with the spending of money we literally don’t have, and entitlement thinking isn’t stopping.-
you are assuming, I think, that new therapies will be like ones we are familiar with -chemo that extends life 6 months for some.
That is not what some of the new ones do. A friend of mine had (“had”) CLL. He has been devoid of any tumor for at least 5 years. One pill a day. No side effects. Very productive life as a doc, taking care of others. Another acquaintance of mine died of melanoma at age 20. I tried to get her on an NIH protocol for a new drug that is a miracle. Jimmy Carter went on it and is apparently doing quite well 5 years after he had liver and brain mets. I couldn’t get her in the trial. She died. Not a 60 year old.
Besides which, try to convince a 60 year old that they should just die now. Or worse, an entire electorate of 60 year olds that it is time for them to go. Good luck with that – get real.
You hit a nerve with the “healthy lifestyle” comment. Healthy lifestyles are worthless in protecting against most cancers, B Cell lymphoma, Melanoma, breast cancer all included. And, I could make a case that we would be better off, overall by taking money spent on “healthy lifestyle” choices – like organic food, nutritional supplements, gym memberships, the entire bogus “natural” movement, and putting it into research or manufacturing of these new treatments.
But I do agree that it is money which we literally do not have. And of course that is the problem.
-
I paraphrase someone:
Medicine should be aimed at providing for the young to grow old, not preventing the old from dying…
In no way supporting eugenics, but end of life care is out of control.
-
Easier said than done. As I get older, Im seeing more and more healthy 70-80+ yr olds contributing to society. My parents being examples. I wouldnt want any healthcare denied them, even if they may disagree themselves.
-
Quote from boomer
I paraphrase someone:
Medicine should be aimed at providing for the young to grow old, not preventing the old from dying…
In no way supporting eugenics, but end of life care is out of control.
This is generally my thought.
I’m very skeptical of the following post re: 70 + being “productive in society.” If there were not such a ridiculous tax burden with threat being thrown in jail, I’d never even bring this up, which is the problem in my estimation. It would be more free for us 40 year olds as 70s, and healthcare would be up to each one of us.-
You can’t compare healthcare systems between countries. The patient populations are too different.
In the US we have more diverse patients from all parts of the world. Different incidents of pathologies from that alone.
Then we have, in general, a very unhealthy lifestyle compared to other countries. That compounds it.
To add even more cost, we have high violet crime. Teens killing teens…costs a lot of manage acute trauma and then if they survive they are in longterm care situations.
Then end of life costs where there’s the desire to keep everyone alive forever…
And then we can go into the higher costs to train our physicians by requiring undergrad studies and then medical school with unlimited loan access (aka inflation to drive the price up of tuition as funds always available).
Finally, the extra cost we incur by allowing ridiculous lawsuits and payouts and the insurance premiums to cover that…
You can’t compare our situation to anyone else as there are way too many factors that go into play. Copying Japan’s hospital system wouldn’t change any of that I mentioned.
-
You cant compare our system to other countries. We just dont have the money for it. Now excuse me while I dump truckloads of money into insurance company and pharmaceutical company coffers and spend hundreds of billions on overpriced military crap that doesnt work.
-
Quote from deadwing
You cant compare our system to other countries. We just dont have the money for it. Now excuse me while I dump truckloads of money into insurance company and pharmaceutical company coffers and spend hundreds of billions on overpriced military crap that doesnt work.
The best part is that it’s a free country we live in and almost every type of political system exists somewhere in the world. So for those that don’t like our system, but prefer communism, monarchies, dictatorships, etc, they are able to go there no problem. 🙂 Much easier for 1 person to make a move like that than to change something for 300+ million.-
When you try to improve a complex system, iteratively select out the most important issue, address, and measure.
If you address too much at once, one never understands what works and what does not, a jumble (ACA).
If you scrap the whole system at once, you risk making things a lot worse.
Iterative change is slow, frustrating and unsexy.
It seems we have a bunch of politicians swinging for the fence. Base hits tend to be the smarter play.-
The ACA was anything but a jumble. It worked and is working even if the mandatory part was removed.
The problem for the politicians is so many constituent actors each concerned with their own concerns.
-
-
Quote from ztune
Quote from deadwing
You cant compare our system to other countries. We just dont have the money for it. Now excuse me while I dump truckloads of money into insurance company and pharmaceutical company coffers and spend hundreds of billions on overpriced military crap that doesnt work.
The best part is that it’s a free country we live in and almost every type of political system exists somewhere in the world. So for those that don’t like our system, but prefer communism, monarchies, dictatorships, etc, they are able to go there no problem. 🙂 Much easier for 1 person to make a move like that than to change something for 300+ million.
Our system is what we choose it to be- the future is open-ended.
“If you don’t like, leave,” implies that arguing for change is not permissible.
-Anti-intellectual and not becoming of a physician.
-
-
-
Quote from ztune
You can’t compare healthcare systems between countries. The patient populations are too different.
In the US we have more diverse patients from all parts of the world. Different incidents of pathologies from that alone.
Then we have, in general, a very unhealthy lifestyle compared to other countries. That compounds it.
To add even more cost, we have high violet crime. Teens killing teens…costs a lot of manage acute trauma and then if they survive they are in longterm care situations.
Then end of life costs where there’s the desire to keep everyone alive forever…
And then we can go into the higher costs to train our physicians by requiring undergrad studies and then medical school with unlimited loan access (aka inflation to drive the price up of tuition as funds always available).
Finally, the extra cost we incur by allowing ridiculous lawsuits and payouts and the insurance premiums to cover that…
You can’t compare our situation to anyone else as there are way too many factors that go into play. Copying Japan’s hospital system wouldn’t change any of that I mentioned.
I have never seen a study that explains how our healthcare system is inefficient (most expensive) due to the differences in population in the US compared to other countries. Please show the data that might explain such. Canada for example is not homogeneous. I believe homogeneity is nothing more than a red herring explaining nothing. Everyone gets sick, everyone needs healthcare at some point, individually or family members.
Our relative unhealthiness makes us the most expensive how? Obesity? Fat people make up the difference between the costs of US and Germany France? Or Japan? Pick a country & show how obesity is the primary factor due to obesity. I know of no such data. Contributing? Yes. But major contributing? Where? I’d like to see the data, not anecdotes.
Old people sucking the system dry? Every other country values its old people and does their very best to keep them alive. Also what data to show that old people make us the most expensive?
Violent crime? Yes we are very violent. This year alone we have over 250 mass killings with guns involved. But is violence the cause of us being the most costly? And if you add violent crime you must add our culture to that mix. Again, data is missing.
Malpractice insurance, defensive medicine and capping jury awards also has not shown to be close to a decisive factor in spite of how annoying these might be.
-
The ACA was anything but a jumble.
Aca was roughly 2,300 pages of law the day it was passed. 7 years post passage some 16,000 additional pages of regulations added.
We can argue the exact number of pages, but Ill stick with a jumble.
How many legislators actually read the whole thing? Bet not many. Did you?
Maybe you should write a book and explain it to the rest of us.
-
Quote from Frumious
Malpractice insurance, defensive medicine and capping jury awards also has not shown to be close to a decisive factor in spite of how annoying these might be.
I take most of your points, but I think you’re underestimating defensive medicine. Defensive medicine infiltrates all areas of medicine. Its to the point that medicine out in the community (especially in the hospital EDs) is not based on evidence and primarily based on checklists predicated on “will I get sued if I don’t order this test?” It’s different in the large academic centers, but out in the community where most of medicine is practiced, there’s so much waste on unnecessary testing, and this is nothing new. You don’t hear a lot of focus on it from people in our field because we benefit from the offshoot of the extra tests, but its hard to ignore all the costs associated with it. -
big questionhow much money will I make as a private practice diagnostic radiologist 2023/2024 (residency/fellowship grad) in Texas
-
Frumious, I cant quote on my mobile device but will try to answer your question about what I meant. That is exactly it. Americans wont accept limits on their care. Or even if they would our politicians are too afraid to make the hard call and tell them the truth that care would need to be limited if the government took away their responsibility to pay for it. You only have to look at the mess that is Medicare to see it. Rather than say no to the patients, device makers and pharmaceutical companies etc., CMS continually takes away from physicians to fund the bankrupt program.
Of course we all know care is never free. In fact if you think its expensive now wait until it is free.
-
Quote from Thread killer
Frumious, I cant quote on my mobile device but will try to answer your question about what I meant. That is exactly it. Americans wont accept limits on their care. Or even if they would our politicians are too afraid to make the hard call and tell them the truth that care would need to be limited if the government took away their responsibility to pay for it. You only have to look at the mess that is Medicare to see it. Rather than say no to the patients, device makers and pharmaceutical companies etc., CMS continually takes away from physicians to fund the bankrupt program.
Of course we all know care is never free. In fact if you think its expensive now wait until it is free.
Then I did not misunderstand your position.
I don’t agree with your conclusion about Americans not accepting limits. Those limits exist now under private insurance. Those limits exist now under Medicare & Medicaid. There is no such thing as the sky is the limit (expect Big Pharma’s pricing, maybe? [:@]) Americans accept limits in everything including their insurance now. Those with money to burn have the option of not accepting limits but reality sometimes puts that conceit down – see Steve Jobs.
As for expense, our costs are more than all other universal healthcare countries, in several cases by 2x as much. So how do they do that? OK, their taxes are higher than ours are. And yet their countries are not crippled by deadly taxes and many have higher living standards and longevity. They have pretty robust economies that compares favorably to ours. Many of their results are better than ours. OK, for the affluent that is not the case but that’s part of our problem.
And regarding expenses, just our administrative costs put us way up there in cost. Coding is one example. No, it won’t go away but it could be a hellova lot less expensive and administratively costly.
Talking about how expensive things “will be” is not taking everything into consideration. Yes, if left status quo it will solve nothing and likely cost more. Another example is how Congress hamstrung Medicare from negotiating drug pricing at the request of Big Pharma knowing Medicare could put a lot of downward pressure on the sky-is-the-limit drug pricing. Why do you think insulin for example ios so much cheaper in Canada than in the US?
As for CMS moving funding, that is correct. It’s creating the illusion that costs are bing contained by robbing Peter to pay Paul. It’s about keeping those rich doctors in line, as if physician reimbursement was the single issue keeping healthcare so expensive.
Because no one is really paying attention to dealing with the problem and so very few have any idea what healthcare costs, the solutions are never discussed. I’ve had people tell me re COBRA for example, that paying $800+/month is robbery, they could get much better coverage for much less if only the government allowed that, or some such dumb argument. Seems we’ve heard that claim in public from some politicians, if only hey could show how that works because in truth is they don’t want to talk about and tackle the real reasons.
Ignorance is bliss.
-
One more thing, while MRI’s are more popular her than in say Canada & European countries, utilization has not shown itself to be a big cause for cost discrepancy either. Yes, more affluence does contribute to more utilization as being poor decreases utilization, the utilization rates in Europe and Canada don’t seem to be higher than ours but their costs are still lower.
I also don’t believe patients are the primary cause of the cost discrepancy.
-
-
Quote from helel
big questionhow much money will I make as a private practice diagnostic radiologist 2023/2024 (residency/fellowship grad) in Texas
Uh, helel…wrong place for this. And you better hope your potential employers don’t find you here on AM and see that you have ONLY posted about how much money you will make. YOU are the sort of greedy little Millennial ruining what was once a much more noble profession. -
Quote from helel
big questionhow much money will I make as a private practice diagnostic radiologist 2023/2024 (residency/fellowship grad) in Texas
I don’t know but what is the price of tea in China? or how much wood does a woodchuck chuck?
-
-
US has the best healthcare system in the world but it is the most expensive because Americans subsidize the rest of the world with the cost of medication, devices, and research as well. I got the same antibiotic in Paris for 1/10th of what it would have cost me here. The physicians fee was actually slightly more than what it would cost here at an urgent care clinic.
Also, the healthcare system is extremely i efficient with layers of middlemen and administrators skimming off the money.
Medicare for all would get administrative costs down by cutting out the middlemen. As a single gigantic entity it would have the ability to negotiate with drug companies and device makers- and yes with hospitals and doctors to lower their prices.
I would like the status quo till I retire but I am sick and tired of hearing healthcare is broken and costs are out of control. I don’t mind taking a Salary shave as long as every entity responsible for raising healthcare costs takes an equal cut.
Anyway, change is coming, if we like it or not. The status quo is unsustainable.
Question is how will you and your group predict and adapt to these changes.-
Quote from grama curizon
I don’t mind taking a Salary shave as long as every entity responsible for raising healthcare costs takes an equal cut.
Anyway, change is coming, if we like it or not. The status quo is unsustainable.Under M4A, doctors will take a large salary (and status) cut, but will still be in business (provided AI doesn’t eliminate some imaging/protocol-heavy specialties). But for a lot of other entities (like useless admins, or some Swiss pharma people sucking off US taxpayer tit) it’s going to be a complete bloodbath. Physician piece of pie is 8% right now.
I agree with the entirety of the rest of your post, except the physician fee in France. I broke my finger in Paris 3 years ago, they charged me 40 euros for physician (not a midlevel) visit, including x ray. No insurance. Here in SF you’ll shell out $500 for urgent care visit with x-ray if you’re self pay. And if you’re stupid enough to go to some physician-owned shop instead of a corporate entity like Kaiser / Dignity / One Medical, then you can also expect a random $1000 bill from some douche who walked in to say hi during the exam.-
Quote from avocado
Quote from grama curizon
I don’t mind taking a Salary shave as long as every entity responsible for raising healthcare costs takes an equal cut.
Anyway, change is coming, if we like it or not. The status quo is unsustainable.Under M4A, doctors will take a large salary (and status) cut, but will still be in business (provided AI doesn’t eliminate some imaging/protocol-heavy specialties). But for a lot of other entities (like useless admins, or some Swiss pharma people sucking off US taxpayer tit) it’s going to be a complete bloodbath. Physician piece of pie is 8% right now.
I agree with the entirety of the rest of your post, except the physician fee in France. I broke my finger in Paris 3 years ago, they charged me 40 euros for physician (not a midlevel) visit, including x ray. No insurance. Here in SF you’ll shell out $500 for urgent care visit with x-ray if you’re self pay. And if you’re stupid enough to go to some physician-owned shop instead of a corporate entity like Kaiser / Dignity / One Medical, then you can also expect a random $1000 bill from some douche who walked in to say hi during the exam.
Excuse me, Bozo, you still haven’t made your clown prediction. I’m only calling you Bozo because I asked before and you never gave a real answer to when this is supposedly going to happen (read: not in our careers)-
Quote from Intermittent Blasting
Quote from avocado
Quote from grama curizon
I don’t mind taking a Salary shave as long as every entity responsible for raising healthcare costs takes an equal cut.
Anyway, change is coming, if we like it or not. The status quo is unsustainable.Under M4A, doctors will take a large salary (and status) cut, but will still be in business (provided AI doesn’t eliminate some imaging/protocol-heavy specialties). But for a lot of other entities (like useless admins, or some Swiss pharma people sucking off US taxpayer tit) it’s going to be a complete bloodbath. Physician piece of pie is 8% right now.
I agree with the entirety of the rest of your post, except the physician fee in France. I broke my finger in Paris 3 years ago, they charged me 40 euros for physician (not a midlevel) visit, including x ray. No insurance. Here in SF you’ll shell out $500 for urgent care visit with x-ray if you’re self pay. And if you’re stupid enough to go to some physician-owned shop instead of a corporate entity like Kaiser / Dignity / One Medical, then you can also expect a random $1000 bill from some douche who walked in to say hi during the exam.
Excuse me, Bozo, you still haven’t made your clown prediction. I’m only calling you Bozo because I asked before and you never gave a real answer to when this is supposedly going to happen (read: not in our careers)
I did, twice! First time when you asked me: [link]https://www.auntminnie.com/forum/fb.ashx?m=599516[/link]
Then again after you claimed I haven’t given you an answer: [link]https://www.auntminnie.com/forum/fb.ashx?m=599745[/link]
TL;DR I don’t think dems will unseat Trump this year, but 2024 once they do they bring M4A with them (as public option or single payer – doesn’t matter). -
If remiss, my apologies. Bold prediction, I’m glad you made it, so on that level at least, I salute you.
I think the post Trump era could bring in socialized medicine, but am not sure how it will manifest itself. I find a January 2026 50% slashing of salaries even less likely, though. Does that mean you think the median salary will go down up to 50%? Just curious. -
Quote from Intermittent Blasting
Does that mean you think the median salary will go down up to 50%? Just curious.
I do think median MD salaries will go down 30-50% under M4A, coupled with midlevel trends. Just look at the salaries everywhere else in OECD. Canada is sometimes brought up as a counter-example but their salaries are still much lower than the US. And the reason Canadian docs make more than UK/German/French/Japanese is because you can easily get a work visa and move 100 miles to the US, so Canada has to maintain higher pay to keep docs from leaving. If M4A happens in the US Canadian docs will see a drop too.
I think it will wary a lot by specialty. Some procedure-heavy specialties will suffer a higher relative drop, especially in the fields where we overprescribe procedures vs more conservative forms of treatment (like in ortho and dermatology).
-
-
-
Quote from grama curizon
US has the best healthcare system in the world but it is the most expensive because Americans subsidize the rest of the world with the cost of medication, devices, and research as well. I got the same antibiotic in Paris for 1/10th of what it would have cost me here. The physicians fee was actually slightly more than what it would cost here at an urgent care clinic.
Also, the healthcare system is extremely i efficient with layers of middlemen and administrators skimming off the money.
Medicare for all would get administrative costs down by cutting out the middlemen. As a single gigantic entity it would have the ability to negotiate with drug companies and device makers- and yes with hospitals and doctors to lower their prices.
I would like the status quo till I retire but I am sick and tired of hearing healthcare is broken and costs are out of control. I don’t mind taking a Salary shave as long as every entity responsible for raising healthcare costs takes an equal cut.
Anyway, change is coming, if we like it or not. The status quo is unsustainable.
Question is how will you and your group predict and adapt to these changes.
Great post, a reasonable person at last is found on here who has an opinion based on facts not hot flashes, like Frumi types.
-
-
-
You’ve outlined it well. Whatever the reasons are, that’s what they are. I am just reporting the outcome. Not saying that we can or should replicate other countries, just that they are doing a (much) better job.
-
Quote from Re3iRtH
You’ve outlined it well. Whatever the reasons are, that’s what they are. I am just reporting the outcome. Not saying that we can or should replicate other countries, just that they are doing a (much) better job.
Not defending our current system-its a mess but comparing the US to other countries is tricky. We are much fatter, have much more inequality with respect to education and wealth, have different expectations with respect to healthcare, are much more of a heterogenous large society etc. Guessing that we also have much more mental health issues….A lot of this also applies to our education. Kinda feel like we will have a truly socialized HC system when we have a socialized educational system (med school free or cheap etc)-
Wait, did someone seriously suggest that the American revolution was modeled on the French? Like, the French Revolution that started around 1789?
-
Also have to point out that in the US , everyone w high level degrees makes more money than elsewhere in the world. True for lawyers , managers , ceos, accountants , etc.
-
Ztune – I know youre being obtuse on purpose but you yourself mentioned forcing others to accept a new health system as being selfish as if the elected government making changes to our system is somehow a single person forcing their will on everyone. Very strange.
In any case the main problem with the modern US is minority rule, I agree with you there, – namely old, rich, white and rural folks getting hugely outsized politically influence and all the resultant wacky and regressive politics that stem from that.
Coincidentally, the sect most likely to support right wing nutjob politics are already on Medicare ahahaha.
-
Trying writing a post sometime without including the words “right wing” in it. You are showing a catty and juvenile nature with each post.
Good, responsible adults are reading these posts. This isn’t Reddit or YouTube.
-
Is right wing considered an insult now….? Probably should be, to be honest.
-
Re: Congress effecting change…again if you dont like politicians producing and enacting legislation I dont know what to tell you. What other process do you want for this? Or youd rather just have political paralysis forever? Im afraid that eventually, who knows when, that bill will come die.
In any case as we can see with our current….leader….congress has abdicated much of its authority in the last 100 years so you have the president and worse unelected judges setting national policy with little recourse.
-
I can see why Trump won.
-
-
-
Quote from jd4540
Quote from Re3iRtH
You’ve outlined it well. Whatever the reasons are, that’s what they are. I am just reporting the outcome. Not saying that we can or should replicate other countries, just that they are doing a (much) better job.
Not defending our current system-its a mess but comparing the US to other countries is tricky. We are much fatter, have much more inequality with respect to education and wealth, have different expectations with respect to healthcare, are much more of a heterogenous large society etc. Guessing that we also have much more mental health issues….A lot of this also applies to our education. Kinda feel like we will have a truly socialized HC system when we have a socialized educational system (med school free or cheap etc)
These are antithetical feelings without data, not even anecdotes. I have yet to see the data that shows our system is 2x more expensive than a substantial number of developed countries offering universal healthcare due to obesity and patient expectations and homogeneity, etc. Can you please supply links to such data because I have never been able to find any. And all the data I do find shows definitely that these opinions are dead wrong.
To illustrate this important pointso often overlooked by critics of U.S. health careit is illuminating to examine the prevalence of obesity by country and the evident correlation between obesity rates and the prevalence of diabetes.
Figure 5.2 does not show obesity rates for the UK (26.9 percent in 2015) and for New Zealand (30.7 percent in 2015). They are high up the obesity scale. I have no explanation for the fact that the prevalence of obesity seems to be particularly high in English-speaking countries. (Could it be that speaking English makes you fat?)
(Illustration) Figure 5.2 Overweight and obesity rates designate overweight and obesity prevalence rates. Age- and gender-adjusted rates of overweight (including obesity), using the 2005 OECD standard population. Measured height and weight in England, Hungary, Korea, Mexico, and the United States; self-reported in other countries.
Source: OECD (2017), Obesity Update 2017, available at [link=http://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf.]http://www.oecd.org/els/h…esity-Update-2017.pdf.[/link]
Reinhardt, Uwe E.. Priced Out (pp. 71-72). Princeton University Press. Kindle Edition.And then finally, people realize there is only so much you can do with utilization control. Were not actually very heavy users of healthcare in America.
Reinhardt, Uwe E.. Priced Out (pp. 160-161). Princeton University Press. Kindle Edition.
Now inequality of wealth certainly does play a significant factor in America.-
People like Frumi don’t believe in biological realities like sex or race so they are naturally confused about terms like “heterogeneous” or “equailty” when it comes to outcomes and coming to decisions on such things = money and stealing from some to give to others.
What’s worse is that she (you never have told me if you were male or female, not that you believe in it so why does it matter?) actively stokes the fire of these problems in a delusional, divisive way.-
I bet ‘they’ believe that ALL races have IDENTICAL IQs too. Anyone who states otherwise is racist.
Frumi is sadly brainwashed on sex and race, but they have a good fundamental understanding of Japan’s vs. US’s healthcare based on above posts.
-
-
Quote from Frumious
Quote from jd4540
Quote from Re3iRtH
You’ve outlined it well. Whatever the reasons are, that’s what they are. I am just reporting the outcome. Not saying that we can or should replicate other countries, just that they are doing a (much) better job.
Not defending our current system-its a mess but comparing the US to other countries is tricky. We are much fatter, have much more inequality with respect to education and wealth, have different expectations with respect to healthcare, are much more of a heterogenous large society etc. Guessing that we also have much more mental health issues….A lot of this also applies to our education. Kinda feel like we will have a truly socialized HC system when we have a socialized educational system (med school free or cheap etc)
These are antithetical feelings without data, not even anecdotes. I have yet to see the data that shows our system is 2x more expensive than a substantial number of developed countries offering universal healthcare due to obesity and patient expectations and homogeneity, etc. Can you please supply links to such data because I have never been able to find any. And all the data I do find shows definitely that these opinions are dead wrong.
To illustrate this important pointso often overlooked by critics of U.S. health careit is illuminating to examine the prevalence of obesity by country and the evident correlation between obesity rates and the prevalence of diabetes.
Figure 5.2 does not show obesity rates for the UK (26.9 percent in 2015) and for New Zealand (30.7 percent in 2015). They are high up the obesity scale. I have no explanation for the fact that the prevalence of obesity seems to be particularly high in English-speaking countries. (Could it be that speaking English makes you fat?)
(Illustration) Figure 5.2 Overweight and obesity rates designate overweight and obesity prevalence rates. Age- and gender-adjusted rates of overweight (including obesity), using the 2005 OECD standard population. Measured height and weight in England, Hungary, Korea, Mexico, and the United States; self-reported in other countries.
Source: OECD (2017), Obesity Update 2017, available at [link=http://www.oecd.org/els/health-systems/Obesity-Update-2017.pdf.]http://www.oecd.org/els/h…esity-Update-2017.pdf.[/link]
Reinhardt, Uwe E.. Priced Out (pp. 71-72). Princeton University Press. Kindle Edition.And then finally, people realize there is only so much you can do with utilization control. Were not actually very heavy users of healthcare in America.
Reinhardt, Uwe E.. Priced Out (pp. 160-161). Princeton University Press. Kindle Edition.Now inequality of wealth certainly does play a significant factor in America.
1. Obesity is only linked to Diabetes? What about CAD, HTN, CVA, osteoarthritis, NASH, low back pain etc? Each of these conditions costs tons of $$$
2. Anecdotally, my mother lives in Eastern Europe half the year and the US the other half. Guess where she chooses to have any type of surgery, procedure? The US, despite the fact that it would be free in Europe. In Europe she has no control of what specialist she actually sees and how many months this will take (unless she pays cash)…My sister’s mother in law who lives in Prague limped around for about 2-3 years waiting for a THA revision. Didn’t complain much due to her expectations. That crap would not fly here.
3. Here is a random excerpt from an article addressing IMR in the US compared to European (homogenous) countries:
“Finally, the authors explore how the U.S. IMR disadvantage varies by racial and education group. They find that the U.S.’s higher post-neonatal mortality rate is driven almost entirely by excess mortality among individuals of lower socioeconomic status. As the authors note, “[b]infants born to white, college-educated, married women in the U.S[/b]. have mortality rates that are essentially indistinguishable from a similar advantaged demographic in Austria and Finland.”
-
1. Where is obesity stated as ONLY linked to diabetes? Obesity is not so unique to America and still does not explain why America’s healthcare costs are in the range of 2x other developed countries’ costs. Where is your data?
2. I don’t know why she would travel to USA. Maybe because you live here? But some western countries do have private insurance that allows them to move to the head of the line. This still makes their system less cost in spite of the private insurance rider as an example that answers your mother’s concerns. As I noted, utilization is not particularly different according to data.
3. “higher post-neonatal mortality rate is driven almost entirely by excess mortality among individuals of lower socioeconomic status. As the authors note, “[b]infants born to white, college-educated, married women in the U.S[/b]. have mortality rates that are essentially indistinguishable from a similar advantaged demographic in Austria and Finland.” ”
This is surprising news? One of the reasons for the ACA is that healthcare is not available to many especially in the lower socioeconomic ranks. It is not troubling that non-white Americans have lower health and less access to healthcare?
-
Fairness and equality are entirely imaginary concepts.
Life doesn’t work that way. If you could somehow take all the money from the rich and redistribute it so that every American has an equal net worth (this is already happening on a lesser scale), within a very short time, things will go back to the same way they were. Because biology doesn’t care about feelings and fairness.
By extension, your dream of “equal access for all” is nice in theory, but this ain’t feasible no matter how much legislation and politics you throw at it.
-
You mean because a goal can never be fully and 100% obtained it is not worth attempting?
No, I don’t agree. In the past Americans always prided themselves on making the better mousetrap even though the old one works well. I’m also of an older generation, the generation that not only dreamed of getting to the Moon but actually did. Not “perfect,” but done.
As the old aphorism says, “The perfect is the enemy of the good.” One does not stop because something is not “perfect.”
Other universal healthcare countries don’t meet the 100% goal either but they do better and for less $ than do we. We have one fo the very best clinical medicine in the world but we price it out of range for very many Americans. Insulin is but one example.
-
All banter aside, may I suggest you read the book “Sapiens: A Brief History of Humankind”. Probably the book of 2017 for me. The insights you would gain from it would no doubt be invaluable.
-
Have it, started but haven’t finished yet.
-
Reality is hard for Frumious. Covetousness is the vice of all vices from the left, and that’s saying a lot.
America has the recipe, freedom creating a better life for all, and now they do everything to throw that away because higher standards of living for poor people aren’t good enough; no, we all have to be poor for them to feel better about life (oh wait, I forgot, Señor Fidel and El Comandante get an exception of luxurious living, these rich get a pass)
They really are that insane, yes. -
Quote from Re3iRtH
All banter aside, may I suggest you read the book “Sapiens: A Brief History of Humankind”. Probably the book of 2017 for me. The insights you would gain from it would no doubt be invaluable.
“Ever since the Cognitive Revolution, Sapiens have been living in a dual reality. On the one hand, the objective reality of rivers, trees and lions; and on the other hand, the imagined reality of gods, nations and corporations. As time went by, the imagined reality became ever more powerful, so that today the very survival of rivers, trees and lions depends on the grace of imagined entities such as the United States and Google.” -Yuval Noah Harari
The radiologist also lives in the hinterland between the real and the ideal- the world of DICOM images.
May I suggest “Tlön, Uqbar, Orbis Tertius,” a short story by Jorge Luis Borges -
Quote from Re3iRtH
Fairness and equality are entirely imaginary concepts.
Yes Re, they are called ideals- you should have been exposed to some of this in the military.
-
The military clearly incentivize doctors to join. If it didn’t, doctors would not participate.
My philosophy in life is to maximize incentives and lifestyle, and minimize drawbacks. Whether in the physical reality or in your own mind.
-
Boomer,
Not really. Same reality, different perspective.
Take a baseball. Scientifically it would be described as a ball of twine and leather weighing a few ounces, certain amount of elasticity and so on.
But to me, its description involves playing catch with my dad, summer practices and games with friends as a teenager and a fun break in the day to check scores on ESPN.
The baseball is a baseball, but it has particular meaning to me beyond its mere physical qualities. And it will have different meanings to others too. Dual reality? Nah. Same reality. Human beings simply assign different meanings to the things in their reality.
Its really important too. For instance, our society depends on the consensus human agreement that bits of gold and scraps of green paper have value.
-
I think he’s taking issue to the conceit of guys like Harari, who are materialists, and don’t know much about the spiritual world, or even try to. Thus, they make silly comments about the “imagined” that you in your post also indicate would contradict Harari’s pretentious (boomer’s word, I think quite accurate) assertion.
-
Quote from Intermittent Blasting
Quote from Thread killer
The government systems work in other countries because they are allowed to just say no and do frequently. Good luck implementing that with our electorate. Even the ones that are clamoring for “free” care.
This, this and this. [i]Yes yes yes. It’s easier for people to be leaders of homogeneous populations, you get way less complainers and you can persuade people towards whatever you call the overall good a lot more easily[/i];Quote from radgrinder
IB,
Agree. This is the idea of social capital. [i]When people in a society have a higher level of trust in one another and a higher sense of community, its much easier to get things done. [/i]
[i]One of the unfortunate side effects of our current divisive tone of politics is that it erodes this social capital. [/i]
It presents ones fellow citizens as they rather than we. So instead of we as a country will benefit overall from XYZ program, it ends up with one group of citizens saying that they (a second group of citizens) are benefiting from XYZ more than the first. And one party of politicians represents group A and another group B, and each party asks for more votes and money from those it represents to more effectively oppose the other group of fellow citizens.
This system can actually be effective and have some benefits. But when the political battle is spread into the non political spheres of a society where people could otherwise cohere and regenerate that precious social capital, its not a good thing.
Here is a political argument against healthcare and some people’s ideas about everything else, that America is “too diverse,” that diversity interferes with people agreeing on values and how the country is run and causes paralyzing disagreement.
For example, from Ross Douthat, religious conservative opinion writer in the NYTimes:
[blockquote]
First, [i]as mass immigration increases diversity, it reduces social cohesion and civic trust[/i]. This is not a universal law, as the economics writer Noah Smith has pointed out; there are counter-examples and ways to resist the trend. However, it is a finding that strongly comports with the real-world experience of Europe and America, where as cultural diversity has increased so has social distrust, elite-populist conflict, and the racial, religious and generational polarization of political parties.[/blockquote] Diversity weakens the nation.
The problem is the reality that many other countries who are “homogeneous” are not, and are as, if not more diverse than is the USA and yet have universal healthcare that is very successful AND run much lass costly than our healthcare system here, and we don’t even have universal healthcare. Douthat’s European examples are all still functioning with the possible exception of the UK due to Brexit. This argument about diversity has appeared in American history as long as we’ve had our Republic but this diversity has made the country stronger.
-
Quote from Frumious
Quote from Intermittent Blasting
Quote from Thread killer
The government systems work in other countries because they are allowed to just say no and do frequently. Good luck implementing that with our electorate. Even the ones that are clamoring for “free” care.
This, this and this. [i]Yes yes yes. It’s easier for people to be leaders of homogeneous populations, you get way less complainers and you can persuade people towards whatever you call the overall good a lot more easily[/i];Quote from radgrinder
IB,
Agree. This is the idea of social capital. [i]When people in a society have a higher level of trust in one another and a higher sense of community, its much easier to get things done. [/i]
[i]One of the unfortunate side effects of our current divisive tone of politics is that it erodes this social capital. [/i]
It presents ones fellow citizens as they rather than we. So instead of we as a country will benefit overall from XYZ program, it ends up with one group of citizens saying that they (a second group of citizens) are benefiting from XYZ more than the first. And one party of politicians represents group A and another group B, and each party asks for more votes and money from those it represents to more effectively oppose the other group of fellow citizens.
This system can actually be effective and have some benefits. But when the political battle is spread into the non political spheres of a society where people could otherwise cohere and regenerate that precious social capital, its not a good thing.Here is a political argument against healthcare and some people’s ideas about everything else, that America is “too diverse,” that diversity interferes with people agreeing on values and how the country is run and causes paralyzing disagreement.
For example, from Ross Douthat, religious conservative opinion writer in the NYTimes:
[blockquote]
First, [i]as mass immigration increases diversity, it reduces social cohesion and civic trust[/i]. This is not a universal law, as the economics writer Noah Smith has pointed out; there are counter-examples and ways to resist the trend. However, it is a finding that strongly comports with the real-world experience of Europe and America, where as cultural diversity has increased so has social distrust, elite-populist conflict, and the racial, religious and generational polarization of political parties.[/blockquote] Diversity weakens the nation.
The problem is the reality that many other countries who are “homogeneous” are not, and are as, if not more diverse than is the USA and yet have universal healthcare that is very successful AND run much lass costly than our healthcare system here, and we don’t even have universal healthcare. Douthat’s European examples are all still functioning with the possible exception of the UK due to Brexit. This argument about diversity has appeared in American history as long as we’ve had our Republic but this diversity has made the country stronger.
I’d like to hear the counter examples (of “diversity”), since they aren’t mentioned I will assume as null that it’s just lip service, which is fairly obvious in this style of writing. Japan proves that a honorable, tight, traditional culture is the example par excellence of social cohesion and trust. Of course they have odd cultural behaviors apart from those points, but that’s a distraction so don’t go there to avoid the issue. What’s more about Japan or China that you don’t hear? “Japanese-nationalism” or “China-ethnic nationalism” or whatever weird similarity you want to make a pejorative term for regarding whatever this BS “white nationalism” keeps coming up over. These cultures are far more “racist” (whatever) than any european society ever was, yet we never hear about them and their sovereign choices. Nor should we. But guys like Frumious aren’t honest, so what does it matter.
Europeans created the most desired locations to live in around the whole world, it is a fact, and all we seem to bitch about or talk about is what degree of vilification these people deserve. Even the Chinese and Japanese, and Koreans, owe their current prosperity in large part to European civilizations, beyond their traditional cultures which of course promote success even more.
Jonathan Haidt, who is quoted here because he’s actually an intellectual and honest man, leaning Democrat, has said,
“Liberal multicultural secular democracy is not a natural occurrence for human nature and trends in America suggest there is a very good chance the US democracy will fail in the next 30 years”
As usual, the “conservatives” or traditionalist or whatever you want to call your enemies, who are the supporters of truth and reality, and how to best deal with it — are right again.
-
I’d first like someone – you cigar? – explain to me exactly what you all mean by “diversity?” Canada has a diverse population & they seem to have a working universal healthcare system.
Do you mean cultural diversity or ethnic? Both? Who are the diverse ethnics or culturalists in the US who would make universal healthcare impossible?
Canada is more diverse than the USA as an example. Ethnic diversity, Israel is higher even than the US. Also Belgium, Switzerland. Where is the cutoff point that makes a difference? And what again is the difference?
Cultural diversity? New Zealand is more diverse, Switzerland, Canada and Belgium again. Yet they all have working universal healthcare. Where is the cutoff point in cultural and again, how is it supposed to throw a monkey wrench in successful universal healthcare?
Explain cigar, AKA, IB.
And all this stuff about European civilizations being the world’s best? When are those yellow and brown ingrates ever going to thank us? Europe also brought 2 World Wars and massive genocide, but let’s not let little things like that interfere with your view of world history. -
Regarding “affordable” healthcare, Missouri showing the problems of the cost of healthcare and how it’s closing hospitals.
[link=https://www.washingtonpost.com/national/the-follow-up-appointment/2019/08/17/1be5ded6-b936-11e9-a091-6a96e67d9cce_story.html]https://www.washingtonpos…a96e67d9cce_story.html[/link]
[size=”2″]By 9 a.m., more than two-dozen people were crowded into the room for what has become the busiest legal docket in rural Butler County. [/size]
[size=”2″] Lots of medical cases again today, the judge said, and then he called court into session for another weekly fight between a hospital and its patients, which neither side appears to be winning. [/size]
[size=”2″] So far this year, Poplar Bluff Regional Medical Center has filed more than 1,100 lawsuits for unpaid bills in a rural corner of Southeast Missouri, where emergency medical care has become a standoff between hospitals and patients who are both going broke. Unpaid medical bills are the leading cause of personal debt and bankruptcy in the United States according to credit reports, and whats happening in rural areas such as Butler County is a main reason why. Patients who visit rural emergency rooms in record numbers are defaulting on their bills at higher rates than ever before. Meanwhile, many of the nations 2,000 rural hospitals have begun to buckle under bad debt, with more than 100 closing in the past decade and hundreds more on the brink of insolvency as they fight to squeeze whatever money theyre owed from patients who dont have it. [/size]
[size=”2″] The result each week in Poplar Bluff, a town of 17,000, has become so routine that some people here derisively refer to it as the follow-up appointment 19 lawsuits for unpaid hospital bills scheduled on this particular Wednesday, 34 more the following week, 22 the week after that. Case after case, a hospital that helps sustain its rural community is now also collecting payments that are bankrupting hundreds of its residents. [/size]
Our system is not working for many of our citizens. It’s placing them in bankruptcy or making them choose whether to have any medical care at all. I do recall many saying using the ED as a viable alternative. That seems to be a big problem since patients are hit with massive bills for doing just that.
-
Quote from Frumious
Regarding “affordable” healthcare, Missouri showing the problems of the cost of healthcare and how it’s closing hospitals.
[link=https://www.washingtonpost.com/national/the-follow-up-appointment/2019/08/17/1be5ded6-b936-11e9-a091-6a96e67d9cce_story.html]https://www.washingtonpos…a96e67d9cce_story.html[/link]
[size=”2″]By 9 a.m., more than two-dozen people were crowded into the room for what has become the busiest legal docket in rural Butler County. [/size]
[size=”2″] Lots of medical cases again today, the judge said, and then he called court into session for another weekly fight between a hospital and its patients, which neither side appears to be winning. [/size]
[size=”2″] So far this year, Poplar Bluff Regional Medical Center has filed more than 1,100 lawsuits for unpaid bills in a rural corner of Southeast Missouri, where emergency medical care has become a standoff between hospitals and patients who are both going broke. Unpaid medical bills are the leading cause of personal debt and bankruptcy in the United States according to credit reports, and whats happening in rural areas such as Butler County is a main reason why. Patients who visit rural emergency rooms in record numbers are defaulting on their bills at higher rates than ever before. Meanwhile, many of the nations 2,000 rural hospitals have begun to buckle under bad debt, with more than 100 closing in the past decade and hundreds more on the brink of insolvency as they fight to squeeze whatever money theyre owed from patients who dont have it. [/size]
[size=”2″] The result each week in Poplar Bluff, a town of 17,000, has become so routine that some people here derisively refer to it as the follow-up appointment 19 lawsuits for unpaid hospital bills scheduled on this particular Wednesday, 34 more the following week, 22 the week after that. Case after case, a hospital that helps sustain its rural community is now also collecting payments that are bankrupting hundreds of its residents. [/size]Our system is not working for many of our citizens. It’s placing them in bankruptcy or making them choose whether to have any medical care at all. I do recall many saying using the ED as a viable alternative. That seems to be a big problem since patients are hit with massive bills for doing just that.
I have worked in Poplar Bluff, MO. Nice little town.
Cape has the contract now.
Sky high commercial rates I am sure.
If you don’t have Medicare or Medicaid bend over. -
Recent article on the cost of healthcare regarding hospital charges and billing and then going after the patients for unlisted charges, out of network providers, co-pays and deductibles and balance billing and no accounting for charges.
[link=https://www.nytimes.com/2019/09/03/health/carlsbad-hospital-lawsuits-medical-debt.html]https://www.nytimes.com/2…uits-medical-debt.html[/link]Carlsbad Medical Center is not the only hospital to have filed reams of lawsuits over unpaid bills. In Memphis, Methodist Le Bonheur Healthcare, a nonprofit hospital, [link=https://www.propublica.org/article/methodist-le-bonheur-healthcare-sues-poor-medical-debt]filed 8,300 lawsuits from 2014 through 2018[/link], including some against its own employees, according to an investigation by the journalism nonprofit groups ProPublica and MLK50.
In Virginia, hospitals [link=https://jamanetwork.com/journals/jama/article-abstract/2737183]filed more than 20,000 lawsuits over patient debt in 2017 alone[/link], according to a study by researchers at Johns Hopkins University. Just five hospitals accounted for half of the resulting wage garnishments in the state.
[b]People across the country are coping with soaring medical costs, opaque pricing and surprise bills, but these issues are felt acutely in one-hospital towns like Carlsbad, where residents have few options for care and must pay whatever prices the hospital sets.[/b]
[b]Hospitals that have little competition can negotiate higher rates, because the insurer wants that hospital in their network, said Sara Collins of the nonprofit Commonwealth Fund. Patient deductibles, which must be paid out of pocket, are rising for almost everyone, she added.[/b]
Nationally, more than one in four consumers in 2018 [link=https://files.consumerfinance.gov/f/documents/201907_cfpb_third-party-debt-collections_report.pdf]were reported to credit bureaus over unpaid [/link][link=https://files.consumerfinance.gov/f/documents/201907_cfpb_third-party-debt-collections_report.pdf]debt[/link], according to the Consumer Credit Protection Bureau. More than half of those reports involved medical bills. One survey of women with breast cancer found that a third of those with health insurance [link=https://meetinglibrary.asco.org/record/166359/abstract]had been referred to bill collectors[/link]; among those without insurance, the number rose to 77 percent.
People confronted with medical debt typically [link=https://www.commonwealthfund.org/sites/default/files/2019-02/Collins_growing_cost_burden_testimony_02-13_2019_0.pdf]drain their savings[/link], the Commonwealth Fund has found, and 43 percent said it lowered their credit rating, suggesting that many of these consumers were reported to collections agencies.
[b]In a presentation to the state legislature in 2015, the mining company Intrepid Potash, a major employer in Carlsbad, calculated that it [link=https://nmlegis.gov/handouts/LHHS%20082415%20Item%2015%20Monopolistic%20Overcharging%20Abuse.pdf]would be cheaper for one of its workers to travel to Hawaii for a gall bladder operation[/link] including airfare for two, and a seven-day island cruise than to get the procedure at the local hospital. The company still encourages employees to seek care out of town when possible.[/b]
In May, a nationwide survey by the RAND Corporation found that private insurers paid Carlsbad Medical Center [link=https://www.rand.org/pubs/research_reports/RR3033.html]five times more than Medicare would have paid for the same services[/link] about twice the figure in the state overall.
Carlsbad Medical Center is owned by Community Health Systems, a chain of hospitals based in Franklin, Tenn. An investigation in 2014 by the Santa Fe New Mexican newspaper found that the three hospitals [link=https://www.santafenewmexican.com/news/health_and_science/steep-hospital-markups-strike-blow-to-uninsured/article_0a8afbd6-d3b9-5a43-a38d-ecbaaf901f0f.html]charging the highest prices in the state were all owned by that chain[/link].
In 2015, the company paid $98 million to the federal government [link=https://www.justice.gov/opa/pr/community-health-systems-inc-pay-9815-million-resolve-false-claims-act-allegations]to settle charges that it had inflated revenue by admitting patients unnecessarily[/link]. Community Health Systems admitted no wrongdoing. -
You’ll get your wish from a Dem socialist … in 2024
Until then Orange Man is gonna continue his winning. -
Quote from Frumious
Recent article on the cost of healthcare regarding hospital charges and billing and then going after the patients for unlisted charges, out of network providers, co-pays and deductibles and balance billing and no accounting for charges.
[link=https://www.nytimes.com/2019/09/03/health/carlsbad-hospital-lawsuits-medical-debt.html]https://www.nytimes.com/2…uits-medical-debt.html[/link]
Carlsbad Medical Center is not the only hospital to have filed reams of lawsuits over unpaid bills. In Memphis, Methodist Le Bonheur Healthcare, a nonprofit hospital, [link=https://www.propublica.org/article/methodist-le-bonheur-healthcare-sues-poor-medical-debt]filed 8,300 lawsuits from 2014 through 2018[/link], including some against its own employees, according to an investigation by the journalism nonprofit groups ProPublica and MLK50.
In Virginia, hospitals [link=https://jamanetwork.com/journals/jama/article-abstract/2737183]filed more than 20,000 lawsuits over patient debt in 2017 alone[/link], according to a study by researchers at Johns Hopkins University. Just five hospitals accounted for half of the resulting wage garnishments in the state.
[b]People across the country are coping with soaring medical costs, opaque pricing and surprise bills, but these issues are felt acutely in one-hospital towns like Carlsbad, where residents have few options for care and must pay whatever prices the hospital sets.[/b]
[b]Hospitals that have little competition can negotiate higher rates, because the insurer wants that hospital in their network, said Sara Collins of the nonprofit Commonwealth Fund. Patient deductibles, which must be paid out of pocket, are rising for almost everyone, she added.[/b]
Nationally, more than one in four consumers in 2018 [link=https://files.consumerfinance.gov/f/documents/201907_cfpb_third-party-debt-collections_report.pdf]were reported to credit bureaus over unpaid [/link][link=https://files.consumerfinance.gov/f/documents/201907_cfpb_third-party-debt-collections_report.pdf]debt[/link], according to the Consumer Credit Protection Bureau. More than half of those reports involved medical bills. One survey of women with breast cancer found that a third of those with health insurance [link=https://meetinglibrary.asco.org/record/166359/abstract]had been referred to bill collectors[/link]; among those without insurance, the number rose to 77 percent.
People confronted with medical debt typically [link=https://www.commonwealthfund.org/sites/default/files/2019-02/Collins_growing_cost_burden_testimony_02-13_2019_0.pdf]drain their savings[/link], the Commonwealth Fund has found, and 43 percent said it lowered their credit rating, suggesting that many of these consumers were reported to collections agencies.
[b]In a presentation to the state legislature in 2015, the mining company Intrepid Potash, a major employer in Carlsbad, calculated that it [link=https://nmlegis.gov/handouts/LHHS%20082415%20Item%2015%20Monopolistic%20Overcharging%20Abuse.pdf]would be cheaper for one of its workers to travel to Hawaii for a gall bladder operation[/link] including airfare for two, and a seven-day island cruise than to get the procedure at the local hospital. The company still encourages employees to seek care out of town when possible.[/b]
In May, a nationwide survey by the RAND Corporation found that private insurers paid Carlsbad Medical Center [link=https://www.rand.org/pubs/research_reports/RR3033.html]five times more than Medicare would have paid for the same services[/link] about twice the figure in the state overall.
Carlsbad Medical Center is owned by Community Health Systems, a chain of hospitals based in Franklin, Tenn. An investigation in 2014 by the Santa Fe New Mexican newspaper found that the three hospitals [link=https://www.santafenewmexican.com/news/health_and_science/steep-hospital-markups-strike-blow-to-uninsured/article_0a8afbd6-d3b9-5a43-a38d-ecbaaf901f0f.html]charging the highest prices in the state were all owned by that chain[/link].
In 2015, the company paid $98 million to the federal government [link=https://www.justice.gov/opa/pr/community-health-systems-inc-pay-9815-million-resolve-false-claims-act-allegations]to settle charges that it had inflated revenue by admitting patients unnecessarily[/link]. Community Health Systems admitted no wrongdoing.I interviewed at Carlsbad Medical Center years back. They wanted to pay the rad less than medicare. LOL
I figured they were gouging commercial payers…
Medicare for all- no more scams.
-
As I’ve said, Martin Armstrong thinks the public utility model with price capping may be the last viable option.
-
Another article on more predatory hospital billing. Non-profit hospitals, indeed.
Yes, who needs Medicare for all with healthcare like this bankrupting people with predatory billing and bill collection. Medicare for all, more “free stuff” Socialism.
[link=https://www.washingtonpost.com/health/uva-has-ruined-us-health-system-sues-thousands-of-patients-seizing-paychecks-and-putting-liens-on-homes/2019/09/09/5eb23306-c807-11e9-be05-f76ac4ec618c_story.html]https://www.washingtonpos…76ac4ec618c_story.html[/link]
The family has lots of company: Over six years ending in June 2018, the health system and its doctors sued former patients more than 36,000 times for over $106 million, seizing wages and bank accounts, putting liens on property and homes and forcing families into bankruptcy, a Kaiser Health News analysis has found.
Unpaid medical bills are a leading cause of personal debt and bankruptcy, with hospitals from [link=https://www.propublica.org/article/methodist-le-bonheur-healthcare-sues-poor-medical-debt]Memphis[/link] to [link=https://www.washingtonpost.com/local/johns-hopkins-hospital-sues-patients-many-low-income-for-medical-debt/2019/05/20/d850cafa-7b19-11e9-a5b3-34f3edf1351e_story.html]Baltimore[/link] criticized for their role in pushing families over the financial edge. But UVA stands out for the scope of its collection efforts and how persistently it goes after payment, pursuing poor as well as middle-class patients for almost all theyre worth, according to court records, hospital documents and interviews with hospital officials and dozens of patients.
UVA sued patients for as little as $13.91 and as much as $1 million during most of that period, until July 2017, when it restricted lawsuits to those owing more than $1,000, the analysis shows.
Every year, the health system sued about 100 of its own employees who also happened to be patients. It garnished thousands of paychecks, largely from workers at lower-pay employers such as Walmart, where UVA took wages more than 800 times.
Under a Virginia program designed to help state and local governments collect debt, it also seized $22 million in state tax refunds to patients with outstanding medical bills in the last six fiscal years most of it without court judgments, said health system spokesman Eric Swensen.
Over many years, it filed thousands of property liens from Albemarle County all the way to Georgia.
Beyond its recovery of debts, UVA dunned some former patients an additional 15 percent for legal costs, plus 6 percent interest on their unpaid bills, which over the course of years can add up to more than the original bill.
The health system also has the most restrictive eligibility guidelines for financial assistance to patients of any major hospital system in Virginia, interviews and written policies show. Savings of only $4,000 in a retirement account can disqualify a family from aid, even if its income is barely above poverty level.
-
Middle class family: losing their house due to surprise medical bill
US physicians: “mY BEaUTiFUl BuAUTIFUL ReD AUDIII [link=https://youtu.be/Lk_YAp8Wh5s?t=145]https://youtu.be/Lk_YAp8Wh5s?t=145[/link] now hold my golden iPhone while i sexually harass a nurse”Time for FTC to investigate medical cartel
-
I think Medicare for All really got punched last night.
The moderate Dems really came in hard against it (is Klobuchar auditioning for VP?) and the progressive just ducked and dodged on cost.
And the whole group finally woke up and stopped bashing Obama.
The big take away for me from last night was that “build on Obamacare” now has the definitive upper hand in the dem primary group.
-
Quote from dergon
I think Medicare for All really got punched last night.
The moderate Dems really came in hard against it (is Klobuchar auditioning for VP?) and the progressive just ducked and dodged on cost.
And the whole group finally woke up and stopped bashing Obama.
The big take away for me from last night was that “build on Obamacare” now has the definitive upper hand in the dem primary group.
More Obamacare subsidies- i.e. corporate subsides is not less expensive than medicare for all
-
Quote from dergon
I think Medicare for All really got punched last night.
The moderate Dems really came in hard against it (is Klobuchar auditioning for VP?) and the progressive just ducked and dodged on cost.
And the whole group finally woke up and stopped bashing Obama.
The big take away for me from last night was that “build on Obamacare” now has the definitive upper hand in the dem primary group.
I agree – although Biden could have done a better job explaining it, fundamentally getting Obamacare passed was an extremely difficult thing to do. It is much smarter to build upon it rather than try to tear it down and replace it with a government run system.
-
Quote from avocado
Middle class family: losing their house due to surprise medical bill
US physicians: “mY BEaUTiFUl BuAUTIFUL ReD AUDIII [link=https://youtu.be/Lk_YAp8Wh5s?t=145]https://youtu.be/Lk_YAp8Wh5s?t=145[/link] now hold my golden iPhone while i sexually harass a nurse”Time for FTC to investigate medical cartel
US physicians = 10% of medical costs
No one trains as long or as expensive.
Hospital lobby/cartel? Ok. But you need to start investigating and reporting accurately, avo -
erm, Chinese Nationalists = War = Taiwan. Chinese nationalism in 2019 = anti-Hong Kong.
Japanese Nationalism = World War 2.
A lot of people spouting off about that which they know little.. -
Quote from Frumious
1. Where is obesity stated as ONLY linked to diabetes? Obesity is not so unique to America and still does not explain why America’s healthcare costs are in the range of 2x other developed countries’ costs. Where is your data?
2. I don’t know why she would travel to USA. Maybe because you live here? But some western countries do have private insurance that allows them to move to the head of the line. This still makes their system less cost in spite of the private insurance rider as an example that answers your mother’s concerns. As I noted, utilization is not particularly different according to data.
3. “higher post-neonatal mortality rate is driven almost entirely by excess mortality among individuals of lower socioeconomic status. As the authors note, “[b]infants born to white, college-educated, married women in the U.S[/b]. have mortality rates that are essentially indistinguishable from a similar advantaged demographic in Austria and Finland.” ”
This is surprising news? One of the reasons for the ACA is that healthcare is not available to many especially in the lower socioeconomic ranks. It is not troubling that non-white Americans have lower health and less access to healthcare?
My mom spends half the year in Europe and the US (different area of country from where I live) as a lifestyle choice…anectodally recently met up with an old family friend who now lives in Argentina but who has dual citiizenship. Recently had THA. Guess where he had it done?
Don’t have time to look up stats but Im confident that we are much fatter than other countries. Also the heterogeneity and wealth inequality in the US skews our HC statistics. My overall point is you’re comparing apples to oranges. I stated our HC system is a mess but simply stating that other countries do xyz and so should we is oversimplifying things. There are a lot of things unique to the US. Why is our higher educational system is so expensive and somewhat inefficient? Why are we one of the few countries that has so much crap and now need storage units? I could go on but gotta run -
Sentinel JAMA article explaining high healthcare costs in the United States-
[link=https://jamanetwork.com/journals/jama/article-abstract/2674671]https://jamanetwork.com/j…ticle-abstract/2674671[/link]Findings In 2016, the US spent 17.8% of its gross domestic product on health care, and spending in the other countries ranged from 9.6% (Australia) to 12.4% (Switzerland). The proportion of the population with health insurance was 90% in the US, lower than the other countries (range, 99%-100%), and the US had the highest proportion of private health insurance (55.3%). For some determinants of health such as smoking, the US ranked second lowest of the countries (11.4% of the US population 15 years smokes daily; mean of all 11 countries, 16.6%), but the US had the highest percentage of adults who were overweight or obese at 70.1% (range for other countries, 23.8%-63.4%; mean of all 11 countries, 55.6%). Life expectancy in the US was the lowest of the 11 countries at 78.8 years (range for other countries, 80.7-83.9 years; mean of all 11 countries, 81.7 years), and infant mortality was the highest (5.8 deaths per 1000 live births in the US; 3.6 per 1000 for all 11 countries). The US did not differ substantially from the other countries in physician workforce (2.6 physicians per 1000; 43% primary care physicians), or nursing workforce (11.1 nurses per 1000). The US had comparable numbers of hospital beds (2.8 per 1000) but higher utilization of magnetic resonance imaging (118 per 1000) and computed tomography (245 per 1000) vs other countries. The US had similar rates of utilization (US discharges per 100000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries. Salaries of physicians and nurses were higher in the US; for example, generalist physicians salaries were $218173 in the US compared with a range of $86607 to $154126 in the other countries.
-
Quote from jd4540
My mom spends half the year in Europe and the US (different area of country from where I live) as a lifestyle choice…anectodally recently met up with an old family friend who now lives in Argentina but who has dual citiizenship. Recently had THA. Guess where he had it done?
Don’t have time to look up stats but Im confident that we are much fatter than other countries. Also the heterogeneity and wealth inequality in the US skews our HC statistics. My overall point is you’re comparing apples to oranges. I stated our HC system is a mess but simply stating that other countries do xyz and so should we is oversimplifying things. There are a lot of things unique to the US. Why is our higher educational system is so expensive and somewhat inefficient? Why are we one of the few countries that has so much crap and now need storage units? I could go on but gotta run
What exactly does this prove other than your family & friend are likely much more affluent than the median American household; your mother can live 1/2 year in Europe & 1/2 year in America. Does she have Medicare, BTW? Or what European insurance pays her American medical bill? Or does she pay cash? And your friend can fly into America for that THA? Also what insurance or cash? Sounds exactly like very affluent foreign types who prefer American medicine and can pay cash.
I stated above & you can easily find it, America likely has the best clinical medical system in the world, [i]if you can afford it! [/i] -
Quote from Frumious
I stated above & you can easily find it, America likely has the best clinical medical system in the world, [i]if you can afford it! [/i]
Frumi- America does not have the best system- just the most expensive.
If we are going to measure the US health “system” we would have to use population statistics.
-
-
-
-
-
-
-
-
-
Quote from Intermittent Blasting
When you really consider the “bang for your buck” of these cancer therapies, it’s almost laughable given the “cost”. I am slackjawed at colleagues who think extending a person’s life with stage 4 disease from 1 month to 3 months is an achievement (of course, given the cost, which they never talk about). I think even giving a person 1-2 years extra with cancer is fool’s errand, given the cost. If costs could truly go down for everyone 20x and we basically shut down the pharmacopeia, I’d be all for it, just in full disclosure. People in interested in living a healthy lifestyle barely need this kind of excess healthcare at this point, and the goalposts keep moving. It’s not a tragedy to die in your late 60s, sorry, that’s what happened to most people in the history of the world, or worse. I say that mostly because this game of healthcare costs has been with the spending of money we literally don’t have, and entitlement thinking isn’t stopping.I agree.
-
-
Quote from drad123
Quote from DoctorDalai
Which of the systems you cited are the choices of those who can afford to go anywhere in the world? NONE of them. Such people go to the United States for the finest care. The results from the English NHS in particular are nothing to be proud of.
You guys have convinced yourselves that poor medicine for all is somehow noble.
American exceptionalism- shades of a Trump supporter.
I have met many great docs from other countries- America doesn’t have a monopoly on intelligence.
straw man alert – Dalai DID NOT say docs in other countries were bad.You made that up.. Read before you write.
as for the phrase “American exceptionalism” you have slapped a label on his argument that some (some only – and those do it with little validity) use as a pejorative. In fact, the care we give is the best in the world. And the Cleveland clinic makes a tidy sum catering to the needs of the foreign rich.
What you DID NOT do was refute in any way what he was saying.-
Quote from Dr.Sardonicus
In fact, the care we give is the best in the world.
And the Cleveland clinic makes a tidy sum catering to the needs of the foreign rich.
What criterion are you using to make the determination that the care in the US is better than every other country? That the Cleveland Clinic makes money treating wealthy foreigners? Specious at best- -
I disagree.
If you can get an equal level of medical care in Tokyo and Kuala Lumpur (and you can), at 10% of the health insurance premium, the U.S. doesn’t give the best healthcare, not even close, speaking in totality.
Anyone employed in Japan pays like $18 a month in health insurance, and their doctors and hospitals are top notch. I think you can call an ambulance for any reason once a month as well.
There is an epidemic of misplaced patriotism in America because most Americans have never traveled outside the U.S. Many don’t have passports, which is baffling to me.
Spending $1200-1800 per month on health insurance is a crime. Biggest rip off. That’s the difference between retirement at age 45 and age 65.
The American health care system is a failure. Mayo clinic and Cleveland clinic catering to billionaires doesn’t make it good.
There is a lot the U.S. can learn from other countries, but blind patriotism prevents this from happening.
-
Quote from Re3iRtH
I disagree.
If you can get an equal level of medical care in Tokyo and Kuala Lumpur (and you can), at 10% of the health insurance premium, the U.S. doesn’t give the best healthcare, not even close, speaking in totality.
Anyone employed in Japan pays like $18 a month in health insurance, and their doctors and hospitals are top notch. I think you can call an ambulance for any reason once a month as well.
There is an epidemic of misplaced patriotism in America because most Americans have never traveled outside the U.S. Many don’t have passports, which is baffling to me.
Spending $1200-1800 per month on health insurance is a crime. Biggest rip off. That’s the difference between retirement at age 45 and age 65.
The American health care system is a failure. Mayo clinic and Cleveland clinic catering to billionaires doesn’t make it good.
Posts like yours are interesting because they imply that other countries have discovered the secret sauce that allows them to provide the same care as Americans get for pennies on the dollar. Essentially turning water into wine. Magical. There is no magic. They are subject to the same economic forces as we are, and no one gets the same health care we get for $18/month.
First – let us be clear what we are arguing about.
I did not and would not say that the US system cannot be improved. I, like virtually every other american, think it is far too expensive. And I will tell you the reasons: 1) Giant healthcare companies (likely you work in one), Insurance companies, and pharmaceutical companies have successfully lobbied the congress to protect their profits. The debate during the ACA period was never about cutting them to 50% of what they take, it was about how, once you have the bill, to divide it up among the populace. 2) Americans DEMAND to have every service known to man, and physicians feel forced to give this. Americans will not accept rationing and will vote out any politician who even whispers the word.
I did say “the care we give is the best in the world”. Nothing about cost there.
I admit that it would be difficult for me to develop one metric we could put on quality of care to say it was “the best” or, as you do “a failure”. So I will have to resort to some generalizations. And of course that will open the door to you for more arguments. Which, because they are futile and time consuming, I won’t participate in.
But let’s look at Japan first. You say that people pay like $18 month for coverage. Your information is wrong. A family of three making 5,000,000 yen per year ($46,000) will pay between 276,000 and 420,000 yen per year ($2578 to $3922) for their health care coverage. That is 5.5% to 11.8% of their income.
[link=https://www.japantimes.co.jp/news/2017/08/11/business/japans-health-care-far-free-ballooning-costs-mean-higher-premiums/#.XUa3I6eZMWo]https://www.japantimes.co…premiums/#.XUa3I6eZMWo[/link]
And that is pre-tax money. The government sets the taxes to cover the difference in what it takes in from premiums and what it pays out to providers. So this 5.5% to 11.8% of the family income does not include what they pay in taxes. The article referred to below says that patient payments paid for 11.7% of all medical expenditures, whereas the tax revenues covered 38.7% – about 3.3 times as much as the direct premium. So, in premiums + Taxes, the hypothetical couple making $46,000 per year will pay between $11,104 and $16,898. Not exactly the $18 per month you were saying. (the balance of the national health care bill is paid by employers, which of course comes out of the pocket of the populace as well, however well hidden.)
FWIW, I have been paying about 9.6% of my income for health care premiums for my wife and I, and this is more expensive than most, as I bought my own insurance, and get no employer contribution.
As for the quality – Well when you say americans have no knowledge of other countries, you picked the wrong guy. I have done primary care in Honduras and Nicaragua. I have experienced the British NHS first hand. Neither were good experiences. I won’t go into details, getting tired of writing
As for the US health care quality, we could go round and round. When I need something done, I get it. And quickly. And with the highest quality providers (I refuse to see midlevels.) When I give health care, the patients get the best there is (not just about me – speaking about all the docs and equipment around me). The oncology service in our hospital can access any of the new treatments. The pathologists are the best there is (within error bars), the surgeons are great, and so on.
Yes, they cost money, but I am not saying that the services provided in the US are the cheapest. The costs do need to come down, and I know where to cut.
here is one other article pointing out that the Japanese system is straining under the cost of the new treatments.
[link=https://www.japantimes.co.jp/news/2017/02/19/national/japans-buckling-health-care-system-crossroads/#.XUazVKeZMWo]https://www.japantimes.co…ossroads/#.XUazVKeZMWo[/link]
one “solution” they had was simply to decree that they would pay 50% of the cost of a new drug. The company that makes it was hurt badly by this price control. Will they still be able to make the drug available? Don’t know.
incidentally, they seem to have a problem with controlling utilization as well
What this cycle of price cuts has caused over the past 50 years is that, Japan has the highest number of MRIs and CT scanners (per 1 million people) in the world and three times more outpatient visits than in the U.S., and the length of hospital stays in Japan is three times longer than in the U.S., Tsugawa said. The sheer volume of medical services consumed in Japan is huge.
But Japan also has a lot to learn from the U.S., especially its superb and standardized education and training systems for doctors, Ishiyama said, adding that Japanese medical education focuses too much on nurturing specialists.
So-called family doctors in Japan are not well trained at detecting illnesses when faced with myriad symptoms, he said, because any independent doctor can claim to practice internal medicine regardless of specialty or training.
And this is written just as the US is dumbing down its primary care delivery personnel – putting essentially untrained NP’s in place of specialist FP’s, IM”s and OB/GYN’s
There is a lot the U.S. can learn from other countries, but blind patriotism prevents this from happening.
And your blind hate for the US prevents you from seeing the good in our system, and the deficiencies in others.-
Blind hate for the US? I love the US. It’s just that I call a spade a spade.
Is it really hard to believe that another country can deliver excellent care at a small fraction of the cost? We know the beaurocracy and corruption that is the US pharmaceutical and insurance industry. The dollars are going to the wrong people. Not hard to imagine that some countries waste money to inflated drug prices and fat secretaries, not to the patient.
You doing medicine in 3rd world countries isn’t much of an argument, my friend. Japan and US are both first world. Apples to apples.
Do you have any friends in Japan? Have you experienced their ER and clinic first hand? No you haven’t. I have both foreign and Japanese friends working in Japan, and they don’t pay anywhere near $80 a month. Less than half of that came out of their paycheck directly (see below). It’s peanuts. And their technology and training is world class. You’re patriotism is blinding you to the truth that America’s healthcare system has failed the people, once the focus became on pharm and insurance companies jets and vacation homes.
I don’t think even you believe that US healthcare dollars are spent efficiently. Google the physician to administrator ratio from 1990 to now.
“The cost of the National Health Insurance varies according to the insured person’s area of residency. In the 23 wards within Tokyo, the monthly fee in 2010 for people who did not need to pay a metropolitan residents tax was 3,325 yen. People with an annual income less than a certain amount may get a 70% or 50% or 20% reduction on their insurance fee.”
[link=https://www.internationalstudentinsurance.com/japan-student-insurance/health-insurance-in-japan.php]https://www.international…insurance-in-japan.php[/link]3325 yen is roughly $28 a month.
-
Personal income tax averages 55% in Japan. And theres a vat tax of 10%
-
Paying 10% of a Radiologist’s salary for healthcare premiums isn’t something to brag about. All due respect. I actually commend you for admitting that! (10% of $500K = $50K a year… Yikes!)
Paying $1500 a month for health insurance should be illegal. I say this as a pretty wealthy person – $1500 a month for health insurance is an absolute rip-off. How do you think a family earning $50K a year feels about paying a mortgage payment to get health care?
-
Blind hate for the US? I love the US. It’s just that I call a spade a spade.
Yep. Reminds me of that awesome opening sceen in [i]Newsroom[/i] where he goes off on how people saying “America is so star-spangled awesome that were the only ones in the world who have freedom?”
” Just in case you accidentally wander into a voting booth one day, theres some things you should know. One of them is: theres absolutely no evidence to support the statement that were the greatest country in the world. Were 7th in literacy, 27th in math, 22nd in science, 49th in life expectancy, 178th in infant mortality, 3rd in median household income, number 4 in labor force and number 4 in exports. We lead the world in only three categories: number of incarcerated citizens per capita, number of adults who believe angels are real and defense spending, where we spend more than the next 26 countries combined, 25 of whom are allies.”-
Quote from dergon
Blind hate for the US? I love the US. It’s just that I call a spade a spade.
Yep. Reminds me of that awesome opening sceen in [i]Newsroom[/i] where he goes off on how people saying “America is so star-spangled awesome that were the only ones in the world who have freedom?”
” Just in case you accidentally wander into a voting booth one day, theres some things you should know. One of them is: theres absolutely no evidence to support the statement that were the greatest country in the world. Were 7th in literacy, 27th in math, 22nd in science, 49th in life expectancy, 178th in infant mortality, 3rd in median household income, number 4 in labor force and number 4 in exports. We lead the world in only three categories: number of incarcerated citizens per capita, number of adults who believe angels are real and defense spending, where we spend more than the next 26 countries combined, 25 of whom are allies.”
Bravo- well written.
-
-
Quote from Re3iRtH
Paying 10% of a Radiologist’s salary for healthcare premiums isn’t something to brag about. All due respect. I actually commend you for admitting that! (10% of $500K = $50K a year… Yikes!)
Paying $1500 a month for health insurance should be illegal. I say this as a pretty wealthy person – $1500 a month for health insurance is an absolute rip-off. How do you think a family earning $50K a year feels about paying a mortgage payment to get health care?
(Don’t assume you know my income. You are wrong.)
obviously you didn’t get the point. It is basically the same amount that the family in Tokyo pays out of pocket. And – they have a much more substantial expense in the form of taxes sent to the health care industry than I do.
AGAIN – IT IS TOO EXPENSIVE. STOP BEATING A DEAD HORSE.
-
Quote from Dr.Sardonicus
Quote from Re3iRtH
Paying 10% of a Radiologist’s salary for healthcare premiums isn’t something to brag about. All due respect. I actually commend you for admitting that! (10% of $500K = $50K a year… Yikes!)
Paying $1500 a month for health insurance should be illegal. I say this as a pretty wealthy person – $1500 a month for health insurance is an absolute rip-off. How do you think a family earning $50K a year feels about paying a mortgage payment to get health care?
(Don’t assume you know my income. You are wrong.)
obviously you didn’t get the point. It is basically the same amount that the family in Tokyo pays out of pocket. And – they have a much more substantial expense in the form of taxes sent to the health care industry than I do.AGAIN – IT IS TOO EXPENSIVE. STOP BEATING A DEAD HORSE.
Irrelevant factoid. Japan might pay more aggregate taxes than we however their health costs are still substantially lower than ours even with a population that is substantially older than ours
From Reinhardt’s book, “Priced out,”
As figure 1.5 shows, there is a wide variance of spending per capita at any population-age level. The U.S. population is, on average, much younger than the populations of many other countries in the OECD, yet we spend so much more per capita on health care. In fact, although the United States has one of the youngest populations among developed nations, we have the worlds highest health spending per capita. Japan, in contrast, has the oldest population but among the lowest health spending levels.
It can be fun to impose a trend line on the data points in figure 1.5. That trend line would have a negative slope, suggesting (spuriously) that the aging of a nations population lowers its per capita health spending. Just two data points would drive that result: the high per capita health spending in the United States, given its relatively young population, and the low health spending per capita in Japan, given its very old population.
Reinhardt, Uwe E.. Priced Out (pp. 18-19). Princeton University Press. Kindle Edition.
-
-
-
Quote from Re3iRtH
Blind hate for the US? I love the US. It’s just that I call a spade a spade.
Is it really hard to believe that another country can deliver excellent care at a small fraction of the cost? We know the beaurocracy and corruption that is the US pharmaceutical and insurance industry. The dollars are going to the wrong people. Not hard to imagine that some countries waste money to inflated drug prices and fat secretaries, not to the patient.
“small fraction” ?? yes it is hard to believe. and my references prove that.
Beyond that READ WHAT I WROTE!! I say it is way to expensive, and give reasons why. Don’t keep hammering on this item as if you are winning a point. That is not in debate
You doing medicine in 3rd world countries isn’t much of an argument, my friend. Japan and US are both first world. Apples to apples.
and is britain 3rd world??
Do you have any friends in Japan? Have you experienced their ER and clinic first hand? No you haven’t. I have both foreign and Japanese friends working in Japan, and they don’t pay anywhere near $80 a month. Less than half of that came out of their paycheck directly (see below). It’s peanuts. And their technology and training is world class. You’re patriotism is blinding you to the truth that America’s healthcare system has failed the people, once the focus became on pharm and insurance companies jets and vacation homes.
Sorry, your second hand, word of mouth testimony I don’t believe is as accurate as the numbers I produced. And – yours doesn’t include the very substantial amount of money they all pay in taxes.
I don’t think even you believe that US healthcare dollars are spent efficiently. Google the physician to administrator ratio from 1990 to now.
That is not at issue here, I agree, drop it.
“The cost of the National Health Insurance varies according to the insured person’s area of residency. In the 23 wards within Tokyo, the monthly fee in 2010 for people who did not need to pay a metropolitan residents tax was 3,325 yen. People with an annual income less than a certain amount may get a 70% or 50% or 20% reduction on their insurance fee.”
[link=https://www.internationalstudentinsurance.com/japan-student-insurance/health-insurance-in-japan.php]https://www.international…insurance-in-japan.php[/link]3325 yen is roughly $28 a month.
from the article I referenced:
A welfare ministry simulation presents a household with a father earning ¥4 million a year, a mother earning ¥1 million as a part-timer and a 12-year-old son. If this family lived in Tokyo (where payments are cheaper than in Osaka due to the larger and younger contributor pool) they would pay as a household about ¥23,000 a month for shakai hoken and about ¥33,500 a month for kokumin hoken.
notice it points out that Tokyo is cheaper than other areas
and:
argue with them.
BTW – that link doesn’t work, so I can’t verify or look for the details.
-
-
Quote from Dr.Sardonicus
Americans DEMAND to have every service known to man, and physicians feel forced to give this. Americans will not accept rationing and will vote out any politician who even whispers the word.
Americans know very little about what is wrong with them or how to fix it- this is what doctors are for. In economics, supplier induced demand (SID) may occur when asymmetry of information exists between supplier and consumer. The supplier can use superior information to encourage an individual to demand a greater quantity of the good or service they supply than the Pareto efficient level, should asymmetric information not exist.
-
-
-
-
Plutarch, Livy, Cicero, Cato … Adams, Jefferson, Madison, Monroe, Hamilton.
Its a continuum. Rome lives.
-
A, probably THE reason American healthcare is so expensive in America is not because of fat people; it’s not because of old people being kept alive unnaturally or any other reasons it’s the “patients’ faults.” Not even overuse. Other countries with significantly lower costs have fat people and old people.And their use is comparable for those with insurance. No, radiologist reimbursement is not a primary cost either any more than pediatricians or GPs although they earn significantly less.
Also consider that other universal healthcare countries treat most all their citizens while we have a significant number of people who have difficulty obtaining care that is affordable – a significant reason they don’t get care. The cost of drugs is also a bar.
The problem is the pricing. That includes profits and administrative costs. Lately in the news is the cost of insulin to patients, not a minor factor for these patients.
I would recommend a new book recently released by Uwe Reinhardt. “Priced out” to learn about the American way of healthcare.
We do probably have one of the best healthcare systems in the world but that requires a caveat, clinically we have one of the best but availability and affordability cause problems for patients which contribute to higher morbidity and other factors reducing our system’s effectiveness compared to other developed countries.
-
This is the one time in every 3rd year or so I support Frumi’s post. See, Frumi, if you post something thoughtful (read: not on politics) I’ll agree with you.
As far as the above posts, I think Dr. Sardonicus is being very precise and thinking critically while the others are not addressing what he’s saying, rather peripherals. I say this being a huge fan of Re3, but he’s getting on a bit of a different roll here.
The biggest issue relates to american politics first, then identity politics second. There is no doubt in my mind that if you have a homogeneous population all pulling in the same direction (we don’t) you can be successful with far more things than any other country. At the very least, you have to have an understood dominant culture. And we’ve lost that due to many selling our country out for marxist relativism over the last 50+ years. One should note that we don’t get immigration by and large from places that have their sht together in these realms.
-
-
If you dont like how things are, move somewhere else rather than try to make your home a better place.
Would expect no other argument from the morally and intellectually bankrupt right wing.
-
Quote from deadwing
If you dont like how things are, move somewhere else rather than try to make your home a better place.
Would expect no other argument from the morally and intellectually bankrupt right wing.
Forcing hundreds of millions to change to whatever you want or assume what they want is selfish. I try and do make my home (community) a better place. Why should I force what I want on someone a thousand miles across the other side of the country if that’s what they don’t want? People get tied up in trying to act nationally when their efforts would have a lot larger impact acting locally. -
Quote from deadwing
If you dont like how things are, move somewhere else rather than try to make your home a better place.
Would expect no other argument from the morally and intellectually bankrupt right wing.
While some certainly say this, many right wingers favor reform in such a way that we don’t trash the good parts of American health care. Can you understand Republican pushback when you have AOC and Bernie saying private health insurance needs to go? I want everyone covered, but I also worry about rationing and doctor pay being slashed (maybe I wouldn’t worry about the second so much if I had gone to med school for free like many countries). Personally, I want those with my life in their hands paid well. Airline pilots and doctors being top of the list. I don’t consider the NHS salary of 100,000 pounds to be fair.-
I always enjoy the maneuver of complaining about something until someone wonders aloud why you stay in that locale, keep using that product or frequenting that restaurant. Because then one gets to feign outrage that someone would ask them to leave. Outrage is a great drug, because when you can invent a reason why someone gave you offense then you dont have to examine the merits of your own behavior or arguments.
Its also boring.
-
The best way is to not participate. Learn what to do to be very healthy, and self insure the rest. I don’t think anyone paying a U.S. health insurance premium thinks they are getting a sweet deal.
-
-
Quote from vomer
While some certainly say this, many right wingers favor reform in such a way that we don’t trash the good parts of American health care. Can you understand Republican pushback when you have AOC and Bernie saying private health insurance needs to go? I want everyone covered, but I also worry about rationing and doctor pay being slashed (maybe I wouldn’t worry about the second so much if I had gone to med school for free like many countries). Personally, I want those with my life in their hands paid well. Airline pilots and doctors being top of the list. I don’t consider the NHS salary of 100,000 pounds to be fair.
What are the good parts of healthcare? Blue Cross and Blue Shield? Aetna? Anthem?
You want everyone covered? You realize a market system insures this will not happen?
Private insurance does not prevent rationing, it does not decrease costs.
It is understandable for a doctor to be concerned about pay. I am concerned about my pay.
Rationing occurs in any economic system.
The economic problem sometimes called the basic or central economic problem asserts that an economy’s finite resources are insufficient to satisfy all human wants and needs.
It is understandable to worry about rationing. If it is done poorly or unfairly some people will be harmed. So far Medicare coverage has been excessively generous.
-
-
-
Quote from drad123
Quote from ztune
Quote from deadwing
You cant compare our system to other countries. We just dont have the money for it. Now excuse me while I dump truckloads of money into insurance company and pharmaceutical company coffers and spend hundreds of billions on overpriced military crap that doesnt work.
The best part is that it’s a free country we live in and almost every type of political system exists somewhere in the world. So for those that don’t like our system, but prefer communism, monarchies, dictatorships, etc, they are able to go there no problem. 🙂 Much easier for 1 person to make a move like that than to change something for 300+ million.
Our system is what we choose it to be- the future is open-ended.
“If you don’t like, leave,” implies that arguing for change is not permissible.
-Anti-intellectual and not becoming of a physician.
How many broken records do we have on this forum? All I read on these forums are too many opinions on what people wish the system was like even though they have zero control over it. Good luck with whatever “change” you plan on making for national healthcare. Focus your efforts on something you can control like in your community and in your hospital as I do. I know what I am doing about improving healthcare in my community. What are you going to do about it?
