health care in France

[mikedev10]

Re: health care in France

Have you ever tried to bargain shop for anything remotely covered by health insurance? It is literally almost impossible to get a quote on what something will cost.

When I got my operation in the US, the doctor literally had no idea. His estimate was more than 200% too low.

The hospital financial planner I spoke to right before the operation (read: the money collector) also did not know. Her estimate provided to me was 40% too low.

My friends who have asked around, have literally had to make a half dozen calls and threats before a number is produced.

All of this goes beyond simple "not my job" division into outright obfuscation.

this is because you're the only one that ever did it, because nobody cares to look. the same will happen if you just call up your local providers for the price of a simple physical. if you call up a free market or cash based provider though, you'll get the price for one right away.

[c1ue]

Re: health care in France

this is because you're the only one that ever did it, because nobody cares to look. the same will happen if you just call up your local providers for the price of a simple physical. if you call up a free market or cash based provider though, you'll get the price for one right away.

Now that I cannot believe.

My operation cost in the order of $35,000.

Even if you only had to pay 5% or 10% as an insurance co-pay, it is not insignificant.

Are you seriously telling me that anyone with any experience anywhere near a hospital OR has no concern for cost?

[Ghent12]

Re: health care in France

Where you are going wrong is in equating a limited resource (true) with insufficient supply (untrue).

If indeed there were so few doctors, and so little equipment, and a teensy amount of available medication, then you could correctly state that scarcity exists.

There is no such thing in the United States.

Under your rationale, the Internet is scarce, because it is limited. The sun is scarce, because it is limited. For that matter, Gaia is scarce because it is only one planet.

All of these above statements are true in some academic sense, but are untrue in the real world sense.

The purpose of my first hand examples - which clearly many other iTulipers can also attest to - is that the cost of health care be it insurance or health care provision has nothing whatsoever to do with scarcity in the vast majority of the US health care 'system'.

Even with all this talk about "the real world" you don't seem to be acknowledging the implications of it. Every single resource related to health and medicine is scarce by definition. Even abundant materials are scarce. Scarce is another word for finite. If you aren't even going to speak the same language, the one used commonly by English-speaking economists, then there is no reason at all for you to reply to my posts.

In fact, based upon your statement, "In neither example is scarcity, quality, or whatever else you can name an issue," it is obvious that you haven't even read what I've been posting and therefore you really shouldn't be replying to them unless and until you know what is being said and has been addressed already. I have not been fixating on scarcity, merely pointing it out to keep your perspective in check--you seem to think that waiting isn't a form of rationing, for example.

You are wrong also that, "It is all about cost." The cost is just the symptom of a market structure gone awry, one which has evolved from some previous structure that was significantly better to the current one that is significantly worse. This evolution clearly was not inevitable (evidence provided by systems in other countries) and has been influenced repeatedly by the extraordinary amount of government interference in the health/medicine/insurance and related markets. Until we acknowledge the root of the problem, we cannot even begin to try to figure out a way to solve it. Had you read my posts, you may have noticed that I've made this point a few times already.

[c1ue]

Re: health care in France

Even with all this talk about "the real world" you don't seem to be acknowledging the implications of it. Every single resource related to health and medicine is scarce by definition. Even abundant materials are scarce. Scarce is another word for finite. If you aren't even going to speak the same language, the one used commonly by English-speaking economists, then there is no reason at all for you to reply to my posts.

As you clearly didn't read my post, then I agree - there is no reason for a discussion to occur.

You have not demonstrated that finite = scarce.

Provide evidence of inability to obtain health care or loss of quality due to health care scarcity - due to supply not cost - to illustrate your point.

Merely repeating that finite = scarce = high prices is ridiculous since other nations face the exact same "scarcity" but without the high prices.

The sad part is that there actually is scarcity in some parts of the US: rural areas.

This scarcity exists not because there aren't enough doctors in the US, but rather because it is literally impossible for a doctor with any amount of education debt to be able to afford to practice in a rural area.

Again, cost is the factor.

[Ghent12]

Re: health care in France

c1ue, stop reading what you want to read. I have not said, "finite = scarce = high prices" because that is not exactly the case. As I said, I only brought up the truism that all resources are scarce to try to bring you back down to reality. In reality, rationing occurs at all times with all products and services, and this occurs because resources are scarce. If you don't believe that being forced to wait is a form of rationing, then you are simply and utterly wrong by definition. If you want to engage in some fantasy discussion, then I would ask you to find someone else to do it with.

[c1ue]

Re: health care in France

In reality[/I], rationing occurs at all times with all products and services, and this occurs because resources are scarce.]

You keep repeating that statement without actually providing any evidence whatsoever that this occurs in health care.

As for waiting - when a UPS delivery is scheduled, you have to wait for it. Is it a case of scarcity?

Ditto for a trade person to come fix your plumbing/electrical/HVAC/whatever. Is this a case of scarcity?

The same can be said for any occupation where the skilled person's time is more valuable than yours.

[Ghent12]

Re: health care in France

c1ue, if you absolutely refuse to acknowledge the definition of economics as being valid or true, then there is really no need to delve into any topic relating to economics.

The wait times you listed are, in fact, implications of scarcity. If there were no scarcity of something, then it would be instantly and perpetually available--something that is essentially only true of breathable air, but even that has a number of exceptions.

Scarcity and rationing are real factors in health care and any other service or product. This is a truism; it's not only intuitively obvious, but it is the rational basis from which all discussion on such a topic must originate or at least acknowledge. As an example, if you want to start a conversation about some physical process, such as air conditioning, then you must acknowledge at least some principles of thermodynamics and physics such as the existence of atoms, the law of conservation of energy, and so forth. If you want to discuss economics, then you must acknowledge that it is a subject that is fundamentally about the study of scarce resources which have alternative uses and, generally speaking, it is very important to understand the implications of that--i.e., because basically every resource is scarce and has alternative uses, it usually must be rationed in one or more ways.

If you have a problem with the word "ration" because of any political connotations of it, then that may be an obstacle for you in this discussion. Please understand, however, that there needn't be any "evidence" presented that rationing occurs in health care or any service or industry because it is understood by the very basic principles of economics that such rationing does exist in some form or another.

[lakedaemonian]

Re: health care in France

In better Thai hospitals where most middle class Thais and almost all foreigners go, there are three things that strike you...

1.) Procedures are often on sale. Banners, posters, and email notices tell you that such and such hospital now has a deal on dental xrays and teeth cleaning or cataract surgery or complete physicals. It's not limited to the mundane. I knew a runner who flew from India when back surgery went on sale. Thailand is openly promoting medical tourism. (Not sure how I feel about it or what it will do to costs for the average citizen, but bargaining/shopping are clearly keeping prices competitive for now.)

2.) Doctors, pharmacies, lab-work, and insurance reps are all under the same roof. Combine that with digital medical records and high speed internet, and you get efficiency that can make you weep.

3.) Because things are working well, general morale (of workers and patients) is very high.

VERY interesting......cheers for the "boots on the ground" opinion.

My wife is trying to convince me to take the family up to Thailand for a holiday and get those full body tune up scans and such done....We just might have to give it a go.

[c1ue]

Re: health care in France

c1ue, if you absolutely refuse to acknowledge the definition of economics as being valid or true, then there is really no need to delve into any topic relating to economics.

The wait times you listed are, in fact, implications of scarcity. If there were no scarcity of something, then it would be instantly and perpetually available--something that is essentially only true of breathable air, but even that has a number of exceptions.

Scarcity and rationing are real factors in health care and any other service or product. This is a truism; it's not only intuitively obvious, but it is the rational basis from which all discussion on such a topic must originate or at least acknowledge. As an example, if you want to start a conversation about some physical process, such as air conditioning, then you must acknowledge at least some principles of thermodynamics and physics such as the existence of atoms, the law of conservation of energy, and so forth. If you want to discuss economics, then you must acknowledge that it is a subject that is fundamentally about the study of scarce resources which have alternative uses and, generally speaking, it is very important to understand the implications of that--i.e., because basically every resource is scarce and has alternative uses, it usually must be rationed in one or more ways.

If you have a problem with the word "ration" because of any political connotations of it, then that may be an obstacle for you in this discussion. Please understand, however, that there needn't be any "evidence" presented that rationing occurs in health care or any service or industry because it is understood by the very basic principles of economics that such rationing does exist in some form or another.

You still haven't produced any actual evidence of scarcity beyond the statement that a wait time indicates scarcity somehow, as opposed to optimization of a skilled specialist's time.

If you insist on a dogmatic interpretation of scarcity without any evidence, then how exactly can any conversation occur?

I've challenged you to produce evidence that there is actual scarcity of health care in the United States as opposed to affordability.

You can show there aren't enough doctors as a percentage of population - which is true in some rural areas but is completely untrue elsewhere.

You can show people dying from procedures which could not be performed due to unavailable doctors/operating rooms/medication/tools - though not insufficient money.

Instead you keep repeating that scarcity must exist.

I absolutely agree scarcity can exist somewhere in principle, but you have yet to show it exists in health care and thence that this scarcity is the reason for the extremely high cost of health care in the United States - both the service and the insurance.

[Ghent12]

Re: health care in France

c1ue, you are confusing scarcity with shortage. I have not been saying there is a shortage. In fact, the scarcity of assets in regards to health care is just a minor issue, but for some reason you have a problem with definitions. Please just accept common economic definitions so that we may actually have a discussion on the topic. Remember, shortage has never been mentioned.

Everything that is limited is scarce, in an economic sense, by definition. It's simply true and there need be no proof unless you wish to challenge the rational foundation of all economic study. In that case you are in an entirely different discussion.

If you want proof of scarcity in health care, then think of any instance which you have ever felt any pain or discomfort. That you were not instantly and completely healed after each incidence indicates that health care services and products are, in fact, scarce. As I said before, essentially the only resource that isn't scarce is breathable air, but even that has exceptions.

It's just an economic principle, and not the main point I am even trying to make. Please abandon your incorrect notions and political connotations for words which have very specific meanings in an economic sense.

[mesyn191]

Re: health care in France

Are you seriously telling me that anyone with any experience anywhere near a hospital OR has no concern for cost?

Pretty much yes although this is starting to change a lil' bit because they know so many people are broke.

The way it works is the people actually doing the healthcare service (ie. EMT, Dr, nurse, tech, etc.) have no idea how much any of this stuff they're doing costs. Or if they do they're told by management to keep their mouths shut. Because what gets billed vs what gets paid by the insurance company vs what the patient (end payer) actually pays are all different numbers that will vary from person to person according to their insurance plan, the hospital/office, and the doctor doing the work MASSIVELY.

If you want to have an idea how much stuff will cost talk to the front office staff in a doctor's office who do the billing, assuming the doctor still does it in house. That is getting outsourced more and more these days so now its just some nurses and phone watchers who know nothing about the financial side of things at all in many of these offices now.

Edit: also the scarcity argument is BS. What scarcity there is in the medical field is artificial or related to the bottom line of someone else (ie. hospital execs, insurance execs, drug company execs yearly bonus). If you get rid of the profit motive and make medical care strictly non profit top to bottom quality of care would sky rocket and things would be much cheaper too.

[c1ue]

Re: health care in France

c1ue, you are confusing scarcity with shortage.

Actually I think you're the one confusing terms:

scar·ci·ty (skârs-t)n. pl. scar·ci·ties 1. Insufficiency of amount or supply; shortage: a scarcity of food that was caused by drought.
2. Rarity of appearance or occurrence: antiques that are valued for their scarcity.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

---

scarcity [ˈskɛəsɪtɪ]n pl -ties1. inadequate supply; dearth; paucity
2. rarity or infrequent occurrence

Collins English Dictionary – Complete and Unabridged © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

Still want to beat on that drum?

I stand by my previous statements.

[Thailandnotes]

Re: health care in France

VERY interesting......cheers for the "boots on the ground" opinion.

My wife is trying to convince me to take the family up to Thailand for a holiday and get those full body tune up scans and such done....We just might have to give it a go.

Bumrungrad is the most famous hospital in Thailand in part because it appeared on the US news show 60 minutes.

http://www.bumrungrad.com/thailandhospital


A three minute video is here and I can testify that it is accurate.
Link: http://www.bumrungrad.com/virtual-to...tual-tour.aspx


Pertinent to this discussion, this leaped out me as soon as I went to the website....

"How much will your treatment cost?
REALCOST lets you find out what
our patients actually paid for over
40 common procedures."


I know several people who live in Japan, China, and other countries in Asia who find the time and money to travel to this hospital to have check ups, surgery, etc.

That said, it is probably the most expensive hospital and there are plenty of other hospitals in Bangkok, a few in Pattaya, and a few in Chiang Mai that offer the same level of care, technology, and expertise for lower prices. Most dentists have a large part of their practice under the roofs of these hospitals. The dental care is generally excellent and inexpensive. (In the US, dentists lobbied out of medicare, and often the prices they are charging in big cities can be beaten by flying to Thailand.)

[Ghent12]

Re: health care in France

Actually I think you're the one confusing terms:

scar·ci·ty (skârs-t)n. pl. scar·ci·ties 1. Insufficiency of amount or supply; shortage: a scarcity of food that was caused by drought.
2. Rarity of appearance or occurrence: antiques that are valued for their scarcity.

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

---

scarcity [ˈskɛəsɪtɪ]n pl -ties1. inadequate supply; dearth; paucity
2. rarity or infrequent occurrence

Collins English Dictionary – Complete and Unabridged © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003

Still want to beat on that drum?

I stand by my previous statements.

Yes, I want to beat on that drum because you are still incorrect. Context is always important. I am using terms as they apply to the context of economics. Please stop being erroneous and obstinate about the vocabulary of economics.

If we were discussing American football and using the term "down," would you cling to your contention that feather pillows, no matter whether they be the team's first, second, third or forth, have nothing to do with the game itself?

Scarcity in economics is a specific term for a specific purpose. Do not dumb the study of economics down by using "Collins English Dictionary" definitions that are not applicable.


With that vocabulary matter hopefully settled, I would appreciate a return to a rational discussion about the root of the problems facing American health care and specifically about methods or steps that may be taken to return to a better place. This little vocabulary foray is only very minor in that context because of your insistence that waiting isn't rationing. What actually matters is how to unwind the leviathan of major insurers and their government enablers/backers.

[c1ue]

Re: health care in France

You've tried to argue that scarcity doesn't imply shortages.

I've challenged you to produce actual examples of shortages as well as scarcity.

You continue to retreat into the theoretical concept of any good which is limited, is by definition scarce.

I've responded with similarly inane examples: The Sun will die in 5 billion years. It is therefore scarce by your definition.

Or to use an economics equally ridiculous example: Food is scarce, because it isn't a free good. But this description of food as an economic good, because it has a theoretical scarcity, is irrelevant when looking at the prices of food because scarcity is by far the least of the factors in food price.

I've further noted that the exact same scarcity principle exists in every single other 1st and 2nd world nation.

Yet they don't have the problems the US has in terms of health care affordability, while enjoying equal health care quality - some better and some worse, but all in the same range.

I really don't see what point you are attempting to illustrate.

A theoretically limited supply is causing health care costs in the US to escalate?

Then provide evidence of this limitation and then explain why the US' problems aren't happening anywhere else.