Back to the OP, it was said in business school, and it is true for anything in life. You want a product that is fast, high quality, and low cost. You can pick any two of those three. You can never have all three.
Which is why we settle for a product that is slow, low quality, and expensive.
This was said in this thread as well. It was also debunked in this thread as refers to UHC.
If you were a sales manager, and you told a client that they had to pick two, while they are currently looking at your competitors that are faster, better, and cheaper, then it is only an excuse that you are making for your laziness, your shoddy workmanship, and your budget overruns.
Fast, when required, (less so when not!), high quality, low cost, still isn’t perfect, so it cannot ever be considered? Gotcha! Good Luck with that!
Also, FYI:
I have a friend who loved vacationing in Mexico over many years, last year he took his 93yr old mother along. Second day she has a fall, smashes her arm, off to hospital. Where he is pressured to operate, cannot wait, etc, over a few days. Several surgeries to badly install pins. Fortunately he had deep pockets. Spends close to 30k and his Mom has been butchered and is now only getting sicker. He finally hires a nurse and they transport her home together. She goes directly into emerg and surgery. He was told she’d have died from the systemic infection within a couple of days! They remove the pins which were now popping out, do the procedure that should have been done to reset her arm and shoulder. They also do cosmetic repair to the horror show huge incisions that were made, and clear her infection. Continued seeing required specialists till it was all set right. Her age didn’t factor into it one little bit. Never even a discussion.
Of course they restored her arm, shoulder, hand function fully, as well repairing the hideous scars. Didn’t matter that it was from a Mexican hospital doing unnecessary things, extremely badly, for money. She is happy and healthy today, and weekly goes in to make gnocchis for his restaurant.
These scenarios you’re imagining are just that…imaginings!
An ambulance bill for more than $3000?
Not only don’t we have stories like this, we don’t have hyper-inflated bills like this either.
It might depend on how we implement UHC. There are different approaches to get there, some of which rely on single-payer, which others rely on keeping the overall system we have and then plugging in the holes to get to full UHC.
If we go the route of a M4A approach, then there will likely be winners & losers, as some will end up much better off and others will end up worse off. It would depend on what % of costs are covered (Medicare has holes in it) and how much doctors & hospitals reacted to the new plan, such as retirements and so forth, which could impact wait times and quality of care.
If we go the route of building on the ACA with more subsidies and so forth, fewer people are impacted in the delivery of their care, as the basic system isn’t changed. But there might be issues with some subsets of the population having insurance that has holes in it, while others would have very good insurance…i.e., inequality of accessibility would remain.
Any approach would have challenges that would have to be overcome. I prefer the least disruptive approach, and then we would continue to plug holes where they are.
She was arrested for not showing up in court not because she couldn’t pay the medical bill. Even the article that you cited states all she had to do was show that she couldn’t pay the bill.
nm
That didn’t keep her from being arrested and jailed. I don’t know if that has ever happened to you, but it can be quite an inconvenience.
If your competitors are really faster and better and cheaper, then you’re correct. But that’s not really what the saying is about - it’s about the people who want Walmart prices with Nordstrom quality and service want their purchase delivered tomorrow. It’s about my husband’s customers who want him to match prices with a competitor when his company offers a better quality widget or offers faster delivery. They have actually said “Distributor X charges less for the same widget” and when he says something to the effect of that’s my lowest price, if they’re less you should order from them , they say “But you deliver tomorrow and they take a week”. Well, delivering tomorrow costs money. It may mean they have more drivers working everyday than they would need to have with more flexible delivery dates. It may mean they end up paying overtime.
You can absolutely design a UHC system with good care ,decent prices and a reasonable wait time. What you can’t do is have good care, reasonable prices and a same or next day appointment for a non-urgent procedure. Because having that excess capacity sitting around costs money. I get a screening mammogram every year. It’s not because I have any symptoms and whether I have it done tomorrow or next month doesn’t really matter medically. But every time I call for an appointment, I am offered multiple time slots for for the next day. That means a machine and technician are just sitting around idle waiting for me to call and that costs money.
Americans are funny . Even as some people have to wait months for an appointment with one of the few doctors who accept their insurance , others will leave doctors who won’t give them a next-day appointment in June for their kid’s camp physical.
Showing up in court would have kept her from being arrested and jailed. The article even says
That is correct. It also says that she wasn’t aware of the summons, but I see the point is missed. When American “healthcare” can turn into “Put your hands behind your back” I think that a serious look at another way is warranted.
My business school didn’t work in just memes. They explained that fast, high quality, and low cost only have meaning in comparison to the alternatives. If your alternative is screwed up enough, improving significantly on all three is perfectly doable.
Welcome to America, where you can lose your home and life savings because you are hit by a car or get cancer.
Theres not really anything we can do about it either. Neither political party has any interest in passing genuine health reform (republicans just want to cut consumer protections while democrats want to increase subsidies in a broken system). The only way we will get true health reform is via ballot initiative.
No, the point wasn’t missed - but that’s actually got nothing to do with healthcare. It’s got to do with not showing up in court when notices were sent , no matter what the court case was about. It would be the same if I were suing her for hitting my car.
In any event, she doesn’t say she was never served- she says she doesn’t recall receiving a bill after she moved or notices to appear in court. Very different statements - I can unequivocally state that I was not served with any personal lawsuit between 2014 and today. No need to rely on lack of recall. Which ( and this is a bit of a hijack) suggests that she did know about the court date when it happened , knows she won’t get as much sympathy if she admits that, but doesn’t want to say she was never notified because there might be proof she was.
You need to start paying more attention to what’s going on with the Democrats. There are numerous “Medicare For All” type schemes that are being proposed. There’s an argument, and some proposals are more “single payer” than others. But still, the argument has shifted mightily since 2016 on the Left.
If you define all three as meaning “next day for everything”, “private room with 3 star Michelin food” and “$1 a year” then sure, something has to give.
But you can have all three when you instead demand that is is fast enough, good enough and cheap enough.
I get that, and I have clients that will complain about not being able to get in today, expecting me to pay to have spare capacity laying around waiting for them. I also have people who call and complain about my prices, and I tell them that they are welcome to find someone cheaper. And, well, I don’t have anyone complain about my quality, as that is my focus.
However, my point is, is that the system that we currently have is slow, inefficient and costly. If you can pay cash for a procedure, or have really great insurance, then sure, you can get in the next day for an elective procedure, but that’s pretty much the only “advantage” that the US system has over pretty much every other system.
And in order for the wealthy to be able to get in the next day, they have to walk by people who need medical treatment, but cannot get it this day, or the next, or ever.
For most of us, we don’t get elective procedures approved by insurance that fast. Like I mentioned upthread, my two times that I invoked my insurance policy took months for approval, even though the doctor was available whenever.
Sure, you have trade off, but the tradeoffs that we have picked is to be slower, more expensive, and lower quality for most people, with some people not having any access to it at all, and only benefiting a very small number of people at the top.
As medical costs continue to rise, more and more employers are going to be dropping or reducing their coverage, or moving more of the premiums to the employee’s side. People are complacent with what they have now, they don’t see the true cost, as their employer pays the bulk of it, and as they rarely use anything more than the most basic of services, they don’t really know how well they would be covered if something truly catastrophic were to occur.
That most people are content with the way the medical system is right now is like saying that most people falling from a building seem content with the way things are going as they pass the 50th floor.
Fine, then let me elaborate on my answer to bobot:
We don’t have stories like this in Canada because not only do we not have medical bills, we don’t have debtors prisons.
If Ted sues Jack for a civil debt and Jack doesn’t show up in court, the court doesn’t issue an arrest warrant. It issues a default judgment in Ted’s favour, declaring that Jack owes Ted money.
Ted can then enforce that through civil process: garnishee Jack’s wages, get the sheriff to seize Jack’s property, sell the judgment debt to a collection agency.
None of that is very pleasant for Jack, but it doesn’t result in Jack spending three nights in jail over a civil debt.
Right, but her hitting your car is a different matter than her having a heart attack.
I don’t get the same impression. Having been sued for a car accident that I happened to be within a mile of, I had no idea that I would be involved, and I am not all that organized with my mail, as I have everything on auto-pay, and there are only a few things that I look out for. I missed a summons or three, and, were it not for the fact that they contacted my insurance, and my insurance got ahold of me, I would have never known until I got picked up on a bench warrant.
Five minutes before I got that call from my insurance company, or if I had been picked up on a bench warrant, I would have also “unequivocally state[d] that I was not served with any personal lawsuit between 2014 and today”, but I would have been wrong. At the same time, I could not prove that I never touched nor even saw the summonses as they made their way to the circular file with all the other junk mail that claims that it is important and that I need to open it NOW.
The suit was thrown out, as it was obvious that I was not involved in any way, but that doesn’t mean that I wouldn’t have spent a night or two in jail over it.
Thank you for this. It all sounded so strange, yet I still doubted myself when I thought there can’t be ‘criminal arrest’ for debt in Canada (‘could there?’).