# Is there any sane way to "shop" for medical care? **URL:** \ **Category:** Great Debates\ **Created:** [August 14, 2009, 12:22am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356 "2009-08-14T00:22:38Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![EddyTeddyFreddy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eddyteddyfreddy/32/18796_2.png) [@EddyTeddyFreddy](https://boards.straightdope.com/u/EddyTeddyFreddy)\ **Post date:** [August 18, 2009, 10:57pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/21 "2009-08-18T22:57:05Z")
> [@Nicest\_of\_the\_Damned](#): > > What do you mean by “public system”? The new healthcare plans in Massachusetts don’t include a private option AFAIK, all the new “affordable” plans are run by insurance companies. > > Massachusetts is not bankrupt. What is this bailout the state is requesting? Where are you getting this info about Massachusetts hospitals and hangnails? > > There have been some bumps in the road with the new healthcare law. I am not ready to call it a success but it’s too early to say it has failed. Yes, precisely. And all the hysterical **bolding!!!** and foaming at the mouth do not prove otherwise. ---
**Author:** ![focusonz](https://avatars.discourse-cdn.com/v4/letter/f/9dc877/32.png) [@focusonz](https://boards.straightdope.com/u/focusonz)\ **Post date:** [August 19, 2009, 2:30am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/22 "2009-08-19T02:30:04Z")
**Massachusetts is bankrupt. The news has not reached the brain stem yet!** > [@](#): > > the long-term financial strain is palpable. Massachusetts already has more than \*\*$13 billion in unfunded state employee health care liabilities \*\*on the books, and that figure increases with each additional hire. > [http://www.heartland.org/article/24266/Massachusetts\_Bucking\_The\_Trend\_On\_State\_Employees\_And\_Not\_In\_A\_Good\_Way.html](http://www.heartland.org/article/24266/Massachusetts_Bucking_The_Trend_On_State_Employees_And_Not_In_A_Good_Way.html) > [@](#): > > Lawmakers had deferred any serious effort to control the state’s runaway health costs. New taxes and feeds imposed in 2008 helped stabilize the plans’ finances, but government and industry officials agreed that the\*\* plan would not be sustainable\*\* without significant steps to slow spending. > [The New York Times - Search](http://topics.nytimes.com/topics/news/national/usstatesterritoriesandpossessions/massachusetts/health-care/index.html) > [@](#): > > The reform has been more expensive than expected, costing $1.1 billion in fiscal 2008 and $1.3 billion in fiscal 2009. In the face of a state budget crisis in fall 2008, Gov. Deval Patrick announced that he will **keep the reform afloat by draining money from safety-net** providers such as public hospitals and community clinics. > [http://pnhp.org/mass\_report/mass\_report\_Final.pdf](http://pnhp.org/mass_report/mass_report_Final.pdf) > [@](#): > > Residents express concern over **looming $5.4 billion Massachusetts deficit** > [Residents express concern over looming $5.4 billion Massachusetts deficit - masslive.com](http://www.masslive.com/news/index.ssf/2009/05/residents_express_concern_over.html) **Massachusetts hospitals and $173 million hangnails?** > [@](#): > > The suit says the hospital will lose more than $100 million next year because the state has lowered Medicaid reimbursement rates and stopped paying Boston Medical ‘reasonable costs’ for treating other poor patients. > [http://www.medicalnewstoday.com/articles/157885.php](http://www.medicalnewstoday.com/articles/157885.php) > [@](#): > > Elaine Ullian, president of Boston Medical Center, said the hospital has suffered significant cuts in state reimbursement this year for the care of the poor and expects further cuts next fiscal year. The new money will not be enough to close its budget gap. “What we do know is that there is a gap of $173 million between the expenses we incur and the payments we receive for treating Medicaid patients,” Ullian said. “We’re hopeful we can work with the administration to bridge this gap.” [http://www.boston.com/news/local/massachusetts/articles/2009/03/26/764m\_in\_stimulus\_funding\_to\_go\_to\_healthcare\_services/](http://www.boston.com/news/local/massachusetts/articles/2009/03/26/764m_in_stimulus_funding_to_go_to_healthcare_services/) **Bailout the state** > [@](#): > > Massachusetts will use **$764 million from the federal stimulus package to shore up healthcare** services and prevent further job and program cuts at hospitals that serve large numbers of poor patients, Governor Deval Patrick said yesterday. > [http://www.boston.com/news/local/massachusetts/articles/2009/03/26/764m\_in\_stimulus\_funding\_to\_go\_to\_healthcare\_services/](http://www.boston.com/news/local/massachusetts/articles/2009/03/26/764m_in_stimulus_funding_to_go_to_healthcare_services/) > [@Nicest\_of\_the\_Damned](#): > > I am not ready to call it a success but it’s too early to say it has failed.. **According to Harvard, MA and Cambridge, MA Professors Health care plan in Massachusetts has failed as of 2/18/2009. The federal single payer plan to white wash over another government mistake!** > [@](#): > > **The nation must not look to Massachusetts’ health reform as a model. If we truly want to provide comprehensive health care for all of us at a price we can afford, we must adopt a single-payer plan.** > [http://pnhp.org/mass\_report/mass\_report\_Final.pdf](http://pnhp.org/mass_report/mass_report_Final.pdf) Pst: Fact is not in evidence! :rolleyes: > [@Nicest\_of\_the\_Damned](#): > > What do you mean by “public system”? Click the links. I quit! I am not going to do everything or anything ever again!. I am going on Medicare and become part of the problem. Yipee bread and circuses for everybody! PS EddyTeddyFreddy can’t handle being **bolded** over by facts! :smack: ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [August 19, 2009, 2:46am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/23 "2009-08-19T02:46:36Z")
Going on Medicare to become part of the problem. Ignorant. The problem is we spend more than any other !st world country and get terrible results. Our medical system is 37th and getting lower all the time. We have 50 million people uncovered. we have an organization that was developed to treat the poor in 3rd world countries that now is providing medical help in Tennessee. People drive from Florida and Texas to Tenn. to get help. They are lined up in huge lines and park overnight to be seen. That is in America. How can you shop for medical care if you are covered. The AMA does not want you to find out which doctors are incompetent. They do not want you to know which ones have had numerous law suits for malpractice. The patient flies blind. We always have. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 19, 2009, 2:58am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/24 "2009-08-19T02:58:54Z")
> [@focusonz](#): > > Click the links. I quit! > I am not going to do everything or anything ever again!. > I am going on Medicare and become part of the problem. > Yipee bread and circuses for everybody! > > PS > EddyTeddyFreddy can’t handle being **bolded** over by facts! :smack: You’re going to a lot of effort to post, but posting in such a way that I find myself tuning you out pretty much within seconds. That’s an unfortunate combination. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [August 19, 2009, 3:00am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/25 "2009-08-19T03:00:48Z")
I think the answer to the subject sentence of this OP is simply, “No, not until the people consuming the benefits are shelling out the money to those that are supplying the benefits.” Insurance has its place; I don’t even doubt there is room for health insurance, in the more catastrophic contexts; but in the end a market is only going to work if the buyer and seller are the ones negotiating, and broad health insurance does not permit this to happen. The situation is not helped by the AMA working to artificially restrict the supply of doctors. ---
**Author:** ![Nicest\_of\_the\_Damned](https://avatars.discourse-cdn.com/v4/letter/n/8baadc/32.png) [@Nicest\_of\_the\_Damned](https://boards.straightdope.com/u/Nicest_of_the_Damned)\ **Post date:** [August 19, 2009, 3:12am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/26 "2009-08-19T03:12:33Z")
> [@focusonz](#): > > Massachusetts is bankrupt. The news has not reached the brain stem yet! The government is having problems now. Given the current state of the economy who isn’t? That’s what a safety net is for. But we aren’t bankrupt. We haven’t had to resort to paying people in IOUs and subway tokens yet. > [@](#): > > Bailout the state Using stimulus funds is not the same thing as a bailout. > [@](#): > > According to Harvard, MA and Cambridge, MA Professors > Health care plan in Massachusetts has failed as of 2/18/2009. > The federal single payer plan to white wash over another government mistake! > > Pst: Fact is not in evidence! :rolleyes: > > Click the links. I quit! > I am not going to do everything or anything ever again!. > I am going on Medicare and become part of the problem. > Yipee bread and circuses for everybody! Right, it’s not a single payer system. That’s why I am asking what you mean by a “public system.” It’s mandatory private insurance subsidized by the government for low income people. I am not convinced it’s the best idea, but at the moment lots of people who didn’t have insurance two years ago have it. It may not be sustainable, I am not completely convinced it is. But I still say it’s too soon to call it a failure. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 19, 2009, 4:03am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/27 "2009-08-19T04:03:18Z")
> [@erislover](#): > > I think the answer to the subject sentence of this OP is simply, “No, not until the people consuming the benefits are shelling out the money to those that are supplying the benefits.” Insurance has its place; I don’t even doubt there is room for health insurance, in the more catastrophic contexts; but in the end a market is only going to work if the buyer and seller are the ones negotiating, and broad health insurance does not permit this to happen. The situation is not helped by the AMA working to artificially restrict the supply of doctors. With the sorts of procedures/services/medical whatnotery available today involving everyone from the butcher, the baker, and the heart-lung machine maker, would it be feasible to negotiate even so? Or, more correctly, feasible to give estimates? And a good idea to go with the low bidder? ---
**Author:** ![ZebraShaSha](https://avatars.discourse-cdn.com/v4/letter/z/eada6e/32.png) [@ZebraShaSha](https://boards.straightdope.com/u/ZebraShaSha)\ **Post date:** [August 19, 2009, 5:17am UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/28 "2009-08-19T05:17:03Z")
> [@focusonz](#): > > **Massachusetts is bankrupt. The news has not reached the brain stem yet!** > > **Massachusetts hospitals and $173 million hangnails?** > **Bailout the state** > **According to Harvard, MA and Cambridge, MA Professors > Health care plan in Massachusetts has failed as of 2/18/2009. > The federal single payer plan to white wash over another government mistake!** > > Pst: Fact is not in evidence! :rolleyes: > > Click the links. I quit! > I am not going to do everything or anything ever again!. > I am going on Medicare and become part of the problem. > Yipee bread and circuses for everybody! > > PS > EddyTeddyFreddy can’t handle being **bolded** over by facts! :smack: What are you, a Time Cube economist? ---
**Author:** ![focusonz](https://avatars.discourse-cdn.com/v4/letter/f/9dc877/32.png) [@focusonz](https://boards.straightdope.com/u/focusonz)\ **Post date:** [August 19, 2009, 1:39pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/29 "2009-08-19T13:39:35Z")
> [@jsgoddess](#): > > You’re going to a lot of effort to post, but posting in such a way that I find myself tuning you out pretty much within seconds. Well you obviously read to the end But lacked the mental discipline and fortitude to click the links to educate yourself Then it is no wonder the US is becoming a nanny state. All I read on these threads are just Words about more words. > [@jsgoddess](#): > > And a good idea to go with the low bidder? Think please! ------ Your decision ‘A’ went to the low bidder. Think please! ------ UHC is intended to reduce costs AKA creating a new player that is assumed will be the lowest bidder. Think please! ------ Your company survival depends on you being the lowest bidder Posts with No facts, no statistics, just preconceptions reveal empty shells living in fear. > [@Nicest\_of\_the\_Damned](#): > > I am not convinced it’s the best idea, but at the moment lots of people who didn’t have insurance two years ago have it **Insurance is irrelevant to the poor unless you use the paperwork to bind their wound.** If you would read and understand the document written by MA professors. > **[mass\_report\_Final.pdf](https://pnhp.org/mass_report/mass_report_Final.pdf)** You would find that fewer poor receive health care now than before the MA plan. I and the MA professors go to the effort to research and report. > [@Nicest\_of\_the\_Damned](#): > > It may not be sustainable, I am not completely convinced it is. But I still say it’s too soon to call it a failure. Just so people tune it out and repeat themselves and continue to live defending their untenable positions. > [@Nicest\_of\_the\_Damned](#): > > I am asking what you mean by a "public system. Read and study this and all the data collected but be forewarned [http://www.meps.ahrq.gov/mepsweb/survey\_comp/ic\_survey/2006/meps11r.htm](http://www.meps.ahrq.gov/mepsweb/survey_comp/ic_survey/2006/meps11r.htm) People living in fear want to stay ignorant. **We’re all on planes. Life is dangerous and complicated and it’s a long way down. You’d rather IMAGINE that you can escape instead of actually try, because if you fail, then you got nothing. Then you’ll give up the chance of something real so that you can hold on to hope. The thing is, hope is for sissies.** > [@erislover](#): > > I think the answer to the subject sentence of this OP is simply, “No, not until the people consuming the benefits are shelling out the money to those that are supplying the benefits.” Insurance has its place; I don’t even doubt there is room for health insurance, in the more catastrophic contexts; but in the end a market is only going to work if the buyer and seller are the ones negotiating, and broad health insurance does not permit this to happen. I agree 1000% but I don’t think it, I know it. Pay cash for most and insure against the catastrophic. > [@erislover](#): > > The situation is not helped by the AMA working to artificially restrict the supply of doctors. Prove it!!! The AMA has not restricted me from becoming my own doctor. I can pick up, read, and understand: medical reference books, medical periodicals, Drug reference books, WebMD , practically any medical source material. I can study the data related to the UHC decision and in so doing I know enough that Obama’s UHC is all a scam And private insurance is not broken and does not need fixing. > [@jsgoddess](#): > > With the sorts of procedures/services/medical **whatnotery** available today The existing Government health care and We the People are at the root of a lot of what is wrong in US health care system. 1. [Tort reform](http://www.policyalmanac.org/health/archive/medical_malpractice_cbo.shtml) of 2% of $2.291 trillion would be $45 billion dollars of savings 2 [Medicare fraud](http://www.msnbc.msn.com/id/22184921) $60 billion dollars of savings 1. Medicare misappropriation 2006 26% of [$325 billion](http://useconomy.about.com/od/fy2008budget/p/2008_Mandatory.htm) would be $84 billion dollars of savings [Misappropriation](http://www.meps.ahrq.gov/mepsweb/data_stats/MEPSnetHC.jsp?Id=5BDCAD4F8FB0D38C) - If you require a wheel chair and have an income between $170,000 and $300,000 per year are you really disabled? (link is good for 7 days)PRESS THE SHOW STATISTICS BUTTON 4.[6% of the people are denied medical service under Medicare](http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/hc/acc/2006/acctocare_4_2_2006.htm) while only 4% are denied under private insurance while 0% are denied when they pay cash or do it themselves. 1. We the People treat medical services performed on their body as so much “whatnotery” 6.\*\* Life sucks and then you DIE. Deal with it!!!\*\* ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [August 19, 2009, 4:56pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/30 "2009-08-19T16:56:38Z")
> [@jsgoddess](#): > > With the sorts of procedures/services/medical whatnotery available today involving everyone from the butcher, the baker, and the heart-lung machine maker, would it be feasible to negotiate even so? Or, more correctly, feasible to give estimates? This is a curious objection, if I understand it. I know not of the machinations behind mass production of pre-sliced loaves of bread. The point is, at every step of the way, the parties to the transaction are the ones that stand to benefit. Broad health insurance completely lacks this feature. It is very far from a “market”-based solution, IMO. > [@](#): > > And a good idea to go with the low bidder? Good question. I suppose that would be up to the consumer. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [August 19, 2009, 5:00pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/31 "2009-08-19T17:00:08Z")
> [@erislover](#): > > The situation is not helped by the AMA working to artificially restrict the supply of doctors. > [@focusonz](#): > > Prove it!!! > The AMA has not restricted me from becoming my own doctor. I can pick up, read, and understand: medical reference books, medical periodicals, Drug reference books, WebMD , practically any medical source material. Of course not. But it would be a remarkably poor state of affairs if we all had to be experts in everything. Actually, I suppose it would be an excellent state of affairs, if we had the resources for it; but, we do not, unless we wish to give up pretty much all of modern technology. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 19, 2009, 5:14pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/32 "2009-08-19T17:14:08Z")
> [@erislover](#): > > This is a curious objection, if I understand it. I know not of the machinations behind mass production of pre-sliced loaves of bread. The point is, at every step of the way, the parties to the transaction are the ones that stand to benefit. Broad health insurance completely lacks this feature. It is very far from a “market”-based solution, IMO. Pre-sliced loaves of bread is a single item. Open heart surgery is a dozen items, each with a different provider–more akin to a house than a loaf of bread… if the house were prone to randomly falling down and the price doubling. I know that people go to places like India to have certain procedures done. I wonder how those quotes are handled. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [August 19, 2009, 5:30pm UTC](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356/33 "2009-08-19T17:30:31Z")
> [@jsgoddess](#): > > Pre-sliced loaves of bread is a single item. I strongly doubt that. But you may choose a more _obviously_ complicated device if you like, such as an automobile or television set. > [@](#): > > Open heart surgery is a dozen items, each with a different provider–more akin to a house than a loaf of bread… if the house were prone to randomly falling down and the price doubling. There are many weird issues with how the market could work for health care but that it is complicated seems hardly a criticism. Pretty much everything is complicated. One might note, for instance, the amount of negotiations necessary to visit a website halfway around the world. Or, to my point, the lack thereof. Health care is only ridicuously itemized now because of the insurance agents standing in the way attempting to save themselves money (at our cost… how quaint). If insurance agents stood in the way of bread, how long would they argue over the packaging, the ties, the knives, the ovens used…? > [@](#): > > I know that people go to places like India to have certain procedures done. I wonder how those quotes are handled. Good question! [Previous page](https://boards.straightdope.com/t/is-there-any-sane-way-to-shop-for-medical-care/506356.md?page=1)