I was just trying to demonstrate that I was hyper-involved in my healthcare spending, which is something I feel as if people are pissed about having to do. And it is something I am unable to do under UHC, which really bothers me.
If he hadn’t needed computer work done, I would have just paid the damn bill. I had checked on costs for the dental work I needed ahead of time, and budgeted for it. And besides, what the hell is wrong with bartering?
How did you arrive at this conclusion?
Kinda curious about that myself. Particularly since my cite in the post just above his directly contradicts his (or her as the case may be) notion.
Many people have to be hyper-involved in their healthcare and healthcare spending, since many people have to deal with a system in which payors benefit from denying claims.
Well, I know as a psychologist, bartering is not ethically encouraged, since it has the potential to be exploitative.
In emergency situations hospitals are required by law to provide care, insured or not, so those with insurance pay for those without already.
Imagine the savings for everyone involved if we could avoid those emergency situations in the first place.
And how do you feel about that?
Why are congressmen who’ve received large contributions from Insurance companies opposing it then?
It makes my mother happy.
Nothing is wrong with bartering, but how many patients are going to have the skillset to be able to barter for that big a bill, and how much barter is a dentist going to be able to accept? I’m glad you had the money (and the orthodontist who worked on my daughter had a time payment plan - insurance only paid 50% of a lot) but there are many people who cannot easily afford an unexpected bill of maybe 10% of their pretax income. I was not able to plan in advance for my root canal.
Should dental care be limited to those of us with money or barterable skills?
There are levels of prevention. I found about this by having my pulse taken before giving blood - and failing. That is a cheap preventative measure. According to my research, when my heartbeat was irregular the chance of my having a stroke was fairly good. My problem was asymptomatic, by the way. I also lost half a thyroid when my doctor, during a regular checkup, did a hands on throat test, and found a lump. Benign, so I’m not sure that there would have been any long term consequences.
Obviously going to the doctor every week just in case is costly and is more likely to cause health problems from infections than solve them.
Why not? They represent a societal cost. At the least, you’d have to count the lost taxes from my not working against the cost of my health care. I contribute in some small part to my company also.
The false positive problem is a far better argument against. How do you assign a value on someone, even over75, dying from this? How small is a small minority? My father and father-in-law are both well over 75, and I’ve never heard of this as an issue - neither have had a diagnosis of thyroid cancer. When I had my thyroid out there was a 1% chance or so that the lump was a cancer that would kill me in a month if not removed - and there was no way of telling until a biopsy was done. I think there must be some value in my not sitting around for a month or two convinced I’d drop over dead at any moment. Silly me. So the value of prevention depends strongly on the cost it is avoiding, as I said.
And back to our main point, at the moment decisions about this kind of thing are done randomly, driven more by affordability than by science. The rich, well insured, person will possibly get more preventative care than makes sense. The poor, uninsured person will get less preventative care than makes sense, and is likely to cost more than is necessary. Since there are cases where preventative care does not make economic sense, isn’t it better to try to steer people to an optimal schedule using a UHC type of plan? You’ll never be perfect, but you can certainly do better.
A cite(warning:PDF) from the Joint Economic Committee for the claim that the Democrats’ bill will significantly raise healthcare costs.
from cite:
It seems dishonest to me to imply that some chart put out by a minority of the Joint Economic Committee represents the actual sayso of that committee.
Get back to us when the majority votes to affirm the accuracy of your chart.
I expect we’ll have a long wait for that.
Nice try with the ad homeniem, but the chart is based on CBO data. Try arguing that that’s biased.
I see no reason to ram this bill through quickly except political ones. Perhaps the feeling is if we don’t do it now it will die for another ten to 20 years. Not if the supporters don’t allow it to happen. I’m also okay with getting something done and then tweaking that as time passes. Why is the status quo preferable to an an imperfect attempt at reform?
I’d like see some real effort spent on public education. I can understand people being wary of “hurry hurry, do it now” That didn’t work out so well with either Iraq or the bailout. Aren’t there reasonable small steps we can take to help cover those in need while we examine the issue? My concern is that too many Dems are putting in amendments to help out their health are contributers.
If Will is right and it’s just the first step toward a single payer system I don’t see that as a horrible alternative either.
My ass is based on DNA.
The presentation of the chart is an attempt to coopt the imprimatur of the Joint Economic Committee.
Such dishonesty merits censure, not your excuses for how “it’s really OK because what they meant to do was put out some Unfudged numbers that will open up America’s minds to the dangers of democrat socialist policies.”
I don’t care what you think they meant to do. If the bastards want to engage in an honest debate, they can at least present their data in an honest light.
Brownback didn’t do that, and it’s pretty obvious that this wasn’t just an innocent mistake on his part.
That’s nice. Did you read the footnote of “that bastard”'s graph, and note where the data come from? Want to talk about the facts? We can wait while you finish posturing.
If the senator lies about who he represents, I’m sure he’s quite capable of lying about whatever data he claims to come from a reliable source.
Do you deny that Sen. Brownback’s presentation is founded in a basis of untruth?
If so, you’re not worth talking to, and if not, you need to realize that any supposed facts which the senator’s tainted graph may attest to need to be dug up and verified from the primary literature. In this case that’s CBO data, not the word of a known deceiver.
If you want to talk about facts, you first need to dig some up actual facts.
Significantly?
My back of the napkin calculation makes it to be an 8.5% increase in 2018 over the smaller number.
That number does not tell us much either all by itself. As I noted in previous posts there are a lot of ways savings can be realized.
Do those CBO numbers take into account new efficiencies (such as decreasing the massive administrative costs we currently have)?
How about reducing bankruptcies? If over 60% of bankruptcies are caused by medical bills today I think that number would have to be drastically reduced if everyone has insurance. How much money do creditors lose in bankruptcy that then spread those costs to other consumers?
Do the numbers assume health care costs continue to rise as they have been these last years or does it assume a flattening of the health care cost price curve?
Does that number account for the money we already spend on paying for uninsured patients (via the government) as well as the price effect that has on insurance costs and cost of services?
I honestly do not know the answers to those questions and others in the same vein. I maintain the number you posted is not terribly useful by itself and being thrown out as it is by a Republican Senator with an axe to grind I cannot help but question the number. I have no doubt it is a “real” number dutifully collected by the CBO but without context it is almost meaningless.
I agree that there are some preventive measures that are likely to be cost effective. The issue is preventive measures as a whole. The question then is there any reason to think any proposed systems are likely to improve the cost effectiveness of preventive programs as a whole? I don’t see any reason to think so. If anything, once political considerations intrude, it’s less likely to be based on valid cost/benefit analysis. (IIRC, mammograms for women 40-49 have been subjected to political pressure even under the current system.)
Your wages are what society pays you - and the resources that you consume - not what you contribute to society. I imagine what you really mean is that you feel you are productive over and above what you consume and that this differential would be reversed if you were incapacitated. Which is valid.
But the comparison here is medical costs. Once you start introducing other factors, you can’t stop at lost productivity due to illness and you have to look at a much broader picture.
Fact is that people would be more cost efficient if they dropped dead the moment they retired. (This is one of the little-discussed aspects of the smoking issue, where anti-smoking advocates like to point to medical costs of lung cancer etc., when in reality it’s widely known to those who’ve studied the matter that smokers save society money, by dying soon into their retirements.) After you factor out medical costs and look at overall productivity, the equation to look at is amount of time spent working versus amount of time spent disabled or retired as a percentage of a lifetime. How preventive medical treatments impact that is a very complex issue and I don’t know if anyone has ever done an analysis of this (or even could). At any rate it could go either way, and it’s not something that you can casually toss off as an assumed savings.
I’m not sure what you’re driving at here. Possibly your father & FIL have never been screened for thyroid cancer.
I tried to find the article that gave the thyroid stat I gave but couldn’t. I did find a similar stat in a different NYT article, which included (among other info relevant to this discussion):
It’s also worth reading the links I provided earlier, in case you haven’t.
Again, what makes you think a UHC type of plan will do better? (Note in particular the third of my previous links which discusses a House bill cosigned by 350 reps that is at odds with medical evidence, but feels right to lay people.)
With something such as mammograms I think private insurance is just as beholden to pressure groups as the government would be. Some things are highly emotional and this is one of them. While on paper it makes sense to delay mammograms to older ages that has little power to sway on a subject such as this. Women are 50+% of the population and if Insurance Company A restricts mammograms to older women while Insurance Company B offers to cover it at lower ages company-A will take a massive PR hit and women will be likely to run to company-B for coverage if they can. The reality of it has little to do with those decisions in a case like this. As such I doubt government would be any better or worse than private insurance at denying mammograms till an older age.
For less hot button medical issues I think the government would be more able to restrict various procedures that the medical community finds of dubious usefulness. The government would be a one-stop shop whereas insurance companies are constantly jockeying to provide a cafeteria-style of coverage that offers this or that in order to lure customers.
I would also think that this would leave the door open to private supplemental coverage insurance. The government covers X, Y & Z. Want to be covered for procedures A, B & C too? Buy extra insurance that will do that for you if you think it is important.
As to the overall “preventative” care being an issue here I think we (or at least I was) conflating “preventative medicine” with “delayed medicine”.
Delayed care is where someone stays at home because they cannot afford to see a doctor. Eventually their condition worsens to the point where they simply must see a doctor and now they are headed to the Emergency Room (they cannot afford to see a doctor…the ER has to see them even if they cannot pay).
Of course the ER visit is monstrously more expensive than seeing a doctor would have been. It also clogs the ER with a lot of cases that are less than critical emergencies.
Maybe you cut your arm. You think nothing of it and put a band-aid on. The next day the cut is inflamed, you use some ointment and think nothing of it. The next day it is really in flamed. You think it would be wise to see a doctor but you cannot afford it and it does not seem an emergency. The next day you wake up and your arm is swollen and you are running a fever with a serious infection that has now spread. Off you go to the ER.
Instead of a $300 visit to the doctor when you should have you now have a bill ranging into the thousands of dollars. Continuing medical issues may also ensue since care was delayed necessitating more visits.
It is here where some real cost savings could be realized.