I’m curious how the medical market can use the advantages of the free market very well. As someone said upthread, medicine and capitalism aren’t good partners. Medical care is far closer to a necessity than a luxury, and demand is more set in stone than pretty much anything else–you can get from point A to point B in a busted up Chevy or a brand new Mercedes, but if you need a heart transplant to live, a liver transplant isn’t going to do you any good. Medicine isn’t really a good free market environment, as either you get what you need, or you continue to suffer. Which basically leads to a point where the market can charge damn near whatever it wants, because the patient has no other options.
You’re welcome. Anytime.
I think you’re confusing health insurance with malpractice insurance which, although related, are two different things.
You mean – like we were all recently forced to bail out so-called “financial experts” on Wall Street for fucking up? Gee, which is more important? Banks and stocks or human lives?
Maybe this hasn’t occurred to you, but there may be some people who, faced with crushing medical bills, opt for suing as a means to obtain money to pay those bills? Didn’t we have someone up-thread suggest that very thing as a way to pay for a hypothetical bike vs. car accident?
Because for someone like me, who has no insurance at all, tort reform won’t make a goddamn bit of difference. “Socializing” health care WILL make a difference for me, for my husband, and for about 50 million other Americans.
All this socialized medicine stuff is all well and good, but how do you expect the doctors, hospital managers and PI lawyers to make any MONEY?
The reasons that socialized medicine won’t be coming to an America near you anytime soon are:
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The trial lawyers make too much money from the medical/hospital system because the legal system allows it.
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The insurance companies make too much money from the insured and from the kickbacks they get from the doctors to be ‘in plan’. Nor will they get to choose how and where you get care, which will cost them money.
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The hospitals won’t be able to charge $6.00 for an aspirin with their bottom up pricing structure.
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The doctors won’t be able to keep their insanely huge houses, expensive cars and fat bank accounts or get freebies in excess from the drug companies.
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The drugcos won’t be able to rake in the millions upon millions of dollars they have been because bulk purchases demand deep discounts.
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The feds won’t be able to nitpick/monitor and restrict the development of new and different and (imagine this) effective treatments because the drugcos will be losing too much cash.
It all boils down here in the good ol’ USofA to the dollar. If you take away the dollar, you take away the motivation, if you take away the motivation the system begins to crumble.
It’s been decades since the American health care system was concerned with the health of Americans instead of the health of their bank accounts.
Thanks for the response. I’ve been doing a little more digging as well, and I think you’re mostly right. Tort reform might not solve the crisis (although I have little doubt that it would help).
I suppose the bigger issue (as represented by this short article from CBS News) is probably that malpractice insurance is skyrocketing because of larger economic issues. In particular, as I said above, insurance companies are covering bad bets at the expense of doctors, and ultimately, us.
That’s right. Ridicule someonewho is asking honest questions. I know this is the Pit, but if all you have is a slightly snide tone, you got nothin’. How about this: you drop the horseshit and actually respond to my questions?
I’m open to being convinced (and don’t even THINK about posting the standard “Oh no you’re not! I know your type!” Pit evasion. It’s weak and stupid. I’m perfectly willing to be convinced, but it’s not going to happen via your hysterical “Won’t someone think of the chiiiiiiiiiiildren?!” tactics.)
No. Read the above linked article. It’s a good synopsis. Much more detailed information can be found by searching. I’m referring specifically to malpractice insurance.
Are you even referring to something I said, or are you simply attempting to poison the well?
This refers to tort reform, which would be a good thing in itself, but I’ve already acknowledged that I was (possibly) mistaken about the magnitude of its role in this issue.
But will it make the 250,000,000 or so of the rest of us paupers?
And more important, why can’t these things be addressed as problems and limitations in our own system, rather than completely dismantling it and replacing it with something that has never been tried in a country with a population as large and as widely geographically distributed as our own?
I mean, what’s the startup cost of even undertaking such a massive project?
Im not sure if Iakm your guy here because I’m opposed to UHC on more than just grounds of efficiency; however, I’d like to point out that you haven’t yet made a prima facie case for the proposition that the stats you cited are due to UHC in those countries. I’m sure you are aware of correlation’s strange relationship with causation.
Right now, we’re paying for the health care of the uninsured through a lot of different, wildly inefficient means. The biggest is probably ERs. People without insurance can still get care at ERs since ERs are not permitted (under most circumstances) to turn them away. ERs are extremely pricey, so a minor problem ends up costing 10x what it should.
Even if the uninsured can get care at ERs/hospitals, they can’t usually get outpatient meds. Which means that often treatable conditions get worse and worse, eventually putting a diabetic, say, into the hospital.
Any time someone gets care and doesn’t pay the bill, the rest of us pay the bill. So, if we continue with the number of uninsured, we’re going to be paupers just paying for these crazily inefficient systemic band-aids.
I did respond to your questions. I also thought you were either incredibly naive or trolling. If the response you got wasn’t what you were hoping for… well, too bad. My opinion is my opinion even if you don’t like it.
Don’t worry - I won’t use the “think of the bullshit” tactic because, not having children myself, it’s not a major concern of mine from a personal viewpoint. Frankly, I’ve never understood how someone under 18 is somehow more entitled to healthcare than someone over 18. I don’t just support healthcare for children, I support it for everyone.
Yes, I was responding to something you said. I was even doing so sincerely.
No - unless you think everyone living in Canada, the UK, Spain, etc. are paupers. Americans aren’t some weird type of human inherently more expensive to maintain than other people.
Downsides:
- Taxes will go up
- You may have to wait in line
Upsides:
- No more health insurance premiums, which will offset tax increases at least partially, and quite possibly entirely for many people
- Everyone will be able to get into the line - unlike now, were 1 in 6 can’t even get in line.
We’ve been trying to “fix the current system” since at least the 1970’s (that’s when I remember HMO’s first becoming THE thing to “fix” the problems) - we’ve had 40 years to “fix the current system” and we have FAILED. Health care costs more and fewer people have access. Maybe we should try a DIFFERENT system, hm…? Because, really, WHAT is so fucking wonderful about our current system? The top few percent get prime care and the rest of the country can go to hell?
The lack of health insurance for my husband - who was born with spina bifida, has diabetes, and probably has cardiovascular disease at this point (although we can’t know for sure) - may cost him his LIFE. Ask me if I care if some other people have to give up a few luxuries in order for him to STAY ALIVE. And, oh yes, some pain relief would be nice.
But hey, you might argue I’m angry (well, I am) but even when I worked for the fucking health care industry (which I did for 13 years) I was in favor of single-payer, “socialized” medicine and stated several times on this very forum that if we moved to a system that truly covered EVERYONE I’d be happy to pay a few more percent in taxes and be out of a job.
What happened, though, is that we still have the same shit system and I no longer have either that job or the healthcare that came with it.
And, you know - we don’t have to go Federal single payer - we could do it by state. That’s MUCH more comparable to the scale of such systems in Europe, which are successful, and also how they do it in Canada (by province), which is also workable (if not perfect - but they our system isn’t perfect, either).
I missed my edit window:
Even if the uninsured can get care at ERs/hospitals, they can’t usually get outpatient meds. Which means that often treatable conditions get worse and worse, eventually putting a diabetic, say, into the hospital. And it means missed work time, disability payments, etc.
Which is why it needs to be changed.
Implementation is a whole seperate debate, for a whole seperate thread. Right now, we’ve got our hands full convinceing the stubborn few that UHC will “turn [them] into paupers”.
OK, fair enough. But ER’s get hammered even harder by malpractice premiums (higher risk of accidents and mistakes).
That’s the issue I am wondering about. If these premiums are largely due to insurance companies offsetting bum investments, won’t healthcare be just as expensive under a socialized system as under the current one? I realize that the debt will be distributed more widely, but wouldn’t we be giving them carte blanche to make every one of us offset their own bad decisions, instead of just the insured?
And what about the problem itself? If most of the cause of prohibitively expensive healthcare is coming from the insurance companies, can we not try to stem that tide (thus allowing medical costs to decrease, leading to a decrease in the cost of health insurance) BEFORE we try to go to a completely different system?
I mean the problem will still be there if it’s not dealt with, right?
I honestly can’t think it’d be worse than the current system where my medical records are available to private insurance companies. We’re currently living in a system where mental health providers will put “adjustment disorder” on the claim form no matter what the actual problem is, simply because it’s the most “innocuous” condition and is the least likely to bite you in the ass, insurance-wise, later on.
I recently had to discuss/debate with my health provider the merits of submitting a more honest (and more serious) diagnosis code to my insurance company. The coverage would be (slightly) better in the short term, but long-term having something like that basically “publicly” declared on my medical records could mean being rejected for coverage in the future. It’s striking (and maddening) that there is actually a question of whether it’s in my best interests to tell my insurance company what’s really going on, in order to get the full coverage I deserve for it under my policy.
Side rant – I just learned that I have an entirely separate deductible for mental health, on top of the deductible for “medical” treatment. So, in essence, I have to pay twice as much out of pocket as someone with, say, diabetes, simply because the Powers That Be have decided that mental health isn’t a “medical” issue. Whiskey Tango Foxtrot. :mad:
The thing is though, people only go to ERs when they feel they have to. What would be the cost differential if they and their families could go see a doctor anytime they feel it might be necessary?
Get off the cross. I’ve been basking in the nourishing rays of the Pit for longer than you have. You can have your opinion, but opinions can be wrong.
It was a metaphor for the larger tactic of “There are sick and uninsured people out there! Have you no heart?!” I didn’t literally mean children. I’d expect a Doper to be able to make the connection.
Alrighty. What? When did I mention anything about supporting the bailout of bankers and fat cats, but not of insurance companies?
Malpractice insurance will still be there in one form or another. Are we going to deal with that problem, or are we going to ignore it?
If, by the “top few percent” you mean “the top 84%”, then you have a point.
If we can address some of the bullshit economic issues, why couldn’t healthcare get less expensive?
I’m sorry for your husband’s problems, but you don’t get to make the decision to open everybody else’s purses. I’m not trying to be evil, but yes, you can put a dollar amount on human lives. We do it routinely every day.
But the expense problem will still be there, and the insurance companies are never corrected for covering bad investments at the cost of the public.
I’m not really understanding the question, so I’ll try to answer what I think the question is. Apologies if I miss the boat entirely.
Depending on the type of UHC we’re talking about, we might be talking about doing away with health insurance as it currently exists (note: This is not the plan either Obama or McCain are proposing) and substituting essentially the Medicare system for everyone. In that system, insurance companies aren’t really major players any longer, though there can be certain private additions made to that larger plan.
If you’re talking purely about malpractice insurance, I simply do not believe it is the driver of our enormous health care costs. It is a factor, but not THE factor.
I don’t know. I’d like to know what percentage of medical care for the average American is comprised of “passed on” costs from medical malpractice insurance. My Google-Fu is failing me.
To tell you the truth, a third of my income is made doing consultant work on systems that are as inefficient as yours. I receive business nationwide only through referrals. Your situation isn’t odd but it is preventable. I have no doubt I will remain just as busy once a system of national healthcare is in place because the premise will be the same no matter which plan is ultimately adopted. Clean claims, electronic submission, direct deposit of payments into providers accounts.
Those that aren’t doing it now won’t have a choice in the future if they want to survive in the healthcare industry.
My sense is that it would still work out cheaper, because preventative maintenance is much, much cheaper overall than treatment.
Situation 1: 100 people feel a mild pain in their chest. They all go to see a doctor ($30 visit, but paid for by UHC). 99 learn it’s nothing serious, and require nothing more. One of them is told they’re in serious danger of a heart attack. But because it was caught early, they can prevent the heart attack with $1000 of treatment now. Total cost to taxpayers: $4000
Situation 2: 100 people feel a mild pain in their chest. None of them go to see a doctor – not worth it, since they’ll have to pay $30 out of their own pocket. 99 of them are fine, and they each saved $30 by not going. The 100th has a heart-attack, and needs $50,000 worth of surgery plus associated tests plus treatments. Total cost to taxpayers: $50,000.
Now, I just made those numbers as an example, but they illustrate the point. Encouraging more people to seek preventative care, by not imposing additional costs for doing so, might save everyone money in the long run.
I thought you just had this conversation in this thread, which is why I’m baffled.
In any case, here are some numbers, though it’s from 2004.
Here is a claim from 2002 that malpractice claims and insurance are less than 2% of health care costs.
Capping malpractice seems to lower costs by 3 to 4 percent.
Ooh, this looks like a good link. Look here and follow the link therein. I don’t have the time right now to read the whole thing, but:
Triage is exactly what American hospital emergency rooms work on. Cut your hand open and need stitches you will wait many hours. That is if you are insured. Then you can not afford it.
Yes, but I’m willing to let you have your wrong opinions. I hope one day you’ll wise up.
Yes, I got it. I find the fact there are uninsured citizens to be APPALLING. I find it boggling that people can find that acceptable.
Didn’t say YOU, PERSONALLY supported that, just pointed that we bailed out Wall Street for bad investments, what’s to stop the government from bailing out insurance companies. Oh, wait, the did - they bailed out AIG.
What, you think malpractice and malpractice cases don’t exist in other countries? They do, OK. Malpractice has not bankrupted other countries’ health systems.
Just because you have health insurance doesn’t mean it’s adequate. There are plenty of people who are insured on paper but who’s actual coverage is shit.
For example, one job I interviewed for (but did not get) offered insurance for outpatient, inpatient, and prescriptions - but had an annual benefit cap of $3,500. TOTAL. For a YEAR. That’s horseshit. Their employee were “insured” but Og help them if they really got sick or injured.
So the number of people with adequate - not Cadillac but adequate - health insurance is significantly less than 84%
It may get slightly less expensive, but the fact is modern healthcare has some inherent costs that just aren’t going away. There is NOT going to be a 50% cut in costs no matter what system is implemented.
And you are obviously of the opinion that my husband doesn’t deserve to live as much as you do. I understand that. You don’t value his life. You don’t even feel it’s worth it to ameliorate his suffering. Fine. Don’t expect me to be happy about, asshole.
The last year I worked for Blue Cross the CEO of the Illinois Plan got a 10 million dollar bonus above and beyond his normal salary. I don’t EVER recall hearing about a government employee getting even a ONE million dollar bonus, much less ten. I think eliminating private health insurance would also eliminate such bonuses and the money can be spent on patients instead of executives.