Goodbye to US HealthCare?

[MulaMan]

Re: Goodbye to US HealthCare?

to think a government monopoly lowers costs is simply criminal ignorance.

A public option is NOT a government monopoly.

Yes any type of government health care will easy lower costs relative to today's cartels.

America spends 16% of GDP on health care - all "socialist" nations spend much, much less about 5% GDP or less.

That is 3X lower - which part of "the facts" do you not understand?

Do you believe the USA government is somehow less effecient than every other "socialist" country on earth?

A government option can easily do much better then what we have today.

The argument is not public option vs. la la land Randian ideological utopia....but public option vs. cartels

[MulaMan]

Re: Goodbye to US HealthCare?

If we deregulate it, we'll start seeing the benefits of a free market.

Define "de-regulation" you are watching Fox News dude.

Did you already forget about how financial "de-regulation" worked?

De-regulation is simply re-regulation so that the rules favor a small group of oligarchs running the country.

I agree that we need massive re-regulation in health care and banking to create a free-market or closer to one.

While you are at it, define free-market, a free-market is NOT equal to NO regulation - you must by definition have a government to regulate a free market.

The current criminal GOP crowd and some democrates invented this "de-regulation" "free-market" concept to play on the ignorance of Americans.

[MulaMan]

Re: Goodbye to US HealthCare?

For all those that believe we need "free market" health care, please outline the steps required to get thier from today?

Just saying "de-regulate" is not enough, will some specific "regulation" be removed from the books or will it be replaced by some other regulation, ect...

Even removing a regulation implies a new regulation by defaulting to an underlying legal construct, at the very bottom is the US constitution.

So de-reguation is a complete meaningless term used by the GOP to screw dumb Americans.

If you do not believe me, then please outline "de-regulated" health care and especially how this would happen without government involvement?

Tort reform....yea I know the GOP fallback...the only idea they have....a good idea but not the answer to providing health care coverage.

The other important question is: do you believe there should be an American Health Care Safety net? if not, poor people or those without cash flow simply die? If they walk into a clinic do we simply bus them somewhere to die? how will that work in a "Free-Market"?

if yes to a safety net, how will that happen without government involvement?

[MulaMan]

Re: Goodbye to US HealthCare?

Fascism is NOT like socialism.

http://en.wikipedia.org/wiki/Fascism

[Ghent12]

Re: Goodbye to US HealthCare?

Really? So you're saying heart transplants will be cheap in the future?

What about cancer treatments, are they getting cheaper?

How much cheaper are anti-AIDS treatments getting?

What about any in-hospital procedure period, are these getting cheaper?

The real world doesn't seem to be conforming to your idealistic vision.

X-ray machines are 100 years old; Roentgen first stumbled on it and the first X-ray device was in 1903. It has taken nearly 100 years for X-rays to become ubiquitous.

For that matter, CAT scans were invented in 1975. Does this mean they'll become cheap in 2075?

How about some examples from the past 3 decades?

Cheap is a relative term, and yes, the actual cost of all procedures and technologies will go down as their supply increases. The price paid is entirely different, and is a function of the supply and demand system as well as the FIRE gauntlet in this case. Consider the actual cost of getting an X-ray done (which is a couple cents more than the cost of the film) and the price charged for such a service. Everything that has to go through the FIRE system gets price added but with zero value added. I thought a fellow iTuliper would understand this concept.

Furthermore, I would once again point to an extremely similar industry: LASIK/PRK and cosmetic surgery. As time goes on, cost and price go down, availability goes up, and quality goes up. What's the difference? One is mostly FIRE-free, and doesn't have nearly the burden of the corporatist system that is draining every cent it can while adding no additional value. Where's the public option for insurance of LASIK/PRK surgery?

Beyond that, I fail to see the point in any of your anti-technology ranting. Are you arguing against the X-ray machine, CAT scans, cancer treatments, new (expensive) AIDS treatments, or merely throwing spaghetti on my refrigerator?

I'm amused because you seem to think that the $1.3T is on top of the existing payments. The reality is that it will not be; if this were not so then the health care industry wouldn't be spending $1M/day to fight it.

The entire point which you still don't seem to understand is that health care spending is something which everyone at every age spends.

The point of a national health care system is that you at least get a minimum level of health care. If you choose to spend more for a higher level of care - that option is perfectly open to you.

Every other nation anywhere near the US' level of prosperity has this choice. And these nations all spend far less per capita and as a percentage of per capital income than the US by a huge margin.

The assertion that health care in the US is better is not borne out by any demographic data whatsoever.

Is it better for those with tons of money? Yes.

But in general health care ANYWHERE is better for those with tons of money.

The point is that the results achieved in the US - mediocre at best - do not justify the spending level. The existing system is not working and will continue to not work.

To complain that there is an additional tax is stupid.

The choice is ultimately between perpetuating a broken system where costs are growing 3x or more faster than income and putting in an alternate system which has proven to be able to both provide both a minimum acceptable level of care as well as drive overall systemic costs down.

The reality is that medical costs even outside the socialized sphere in other nations are also lower.

Arguments about technology, about doctors, etc etc are also similarly stupid.

New technology that is useful makes money ANYWHERE and under ANY system.

Doctors who presently migrate to the US to make more money equally can migrate to other nations or not; I very much doubt that most of them will switch to being bankers or ditch diggers assuming these individuals truly are motivated to professionally practice as opposed to become wealthy. If on the other hand they're just reaping profits - it is debatable how beneficial having such practitioners are to begin with.

The simple fact is that the bill in Congress is added directly to current expenses. It will cut MediCare, but will add its own costs directly on top of current expenses paid--unless you think that the entire system will change overnight?

Also, you really consider the results of the US to be mediocre at best? I'll chalk that up to rhetorical flourish unless you repeat it. The majority of world R&D is financed and performed in the US, and the results speak for themselves. Granted, I think seven different cures for erectile dysfunction is a bit much, but you can't deny the march of technology and its positive impact on health care.

One more thing. Going back to AIDS treatment--there was no such thing when it first struck. How dare someone charge money to provide a life-saving service?! :rolleyes:
Does that meet your three decade mark?

[Ghent12]

Re: Goodbye to US HealthCare?

Fascism is NOT like socialism.

http://en.wikipedia.org/wiki/Fascism

Country A has one-party rule. There is a small group of elites that control nearly all the wealth and power in Country A, but in various delegations. Individualism is abhorred, and everyone in Country A is supposed to work for the greater good.

Country B, however, is completely different. It actually has a few groups of elites that control nearly all the wealth and power in Country B. Collectivism is the name of the game for Country B, which is ruled under a single party.


Which country, Country A or Country B, is fascist and which one is socialist?

[grapejelly]

Re: Goodbye to US HealthCare?

For all those that believe we need "free market" health care, please outline the steps required to get thier from today?

Just saying "de-regulate" is not enough, will some specific "regulation" be removed from the books or will it be replaced by some other regulation, ect...

Even removing a regulation implies a new regulation by defaulting to an underlying legal construct, at the very bottom is the US constitution.

So de-reguation is a complete meaningless term used by the GOP to screw dumb Americans.

If you do not believe me, then please outline "de-regulated" health care and especially how this would happen without government involvement?

let anyone buy any insurance they want to.

Let any insurance company offer any product they want to.

Get rid of employer deductibility of health care.

Let people deduct their entire insurance premiums and all medical expenses from their taxable income

Assign risky individuals to insurance companies on a mandatory basis in proportion to that insurance company's market share

Get rid of Medicare and Medicaid completely

If people can't afford medical care, then give them money to pay for their medical care.

Stop treating people who are indigent at hospital emergency rooms. This creates enormous costs by socializing risk and making it possible for people to rationally self insure.

Deregulate medical care so people can go to anyone they want, MD or not, and deduct the entire expense. Remove licensing and guild barriers to health care.

[c1ue]

Re: Goodbye to US HealthCare?

Furthermore, I would once again point to an extremely similar industry: LASIK/PRK and cosmetic surgery. As time goes on, cost and price go down, availability goes up, and quality goes up. What's the difference? One is mostly FIRE-free, and doesn't have nearly the burden of the corporatist system that is draining every cent it can while adding no additional value. Where's the public option for insurance of LASIK/PRK surgery?

Your examples are flawed because no one NEEDS LASIK/PRK nor cosmetic surgery. If the costs vs. benefits are too low, zero procedures are performed.

The real world of health care doesn't have this option. This is exactly why veterinary medicine is also different - ultimately the animal's objective worth is very low and in turn also keeps costs down.

Outside of some billionaire cloning their dog/cat - most people cannot and will not spend tens of thousands of dollars on their pet. Transfer the same condition to their own lives and the situation changes.

Again, apples and oranges.

Beyond that, I fail to see the point in any of your anti-technology ranting. Are you arguing against the X-ray machine, CAT scans, cancer treatments, new (expensive) AIDS treatments, or merely throwing spaghetti on my refrigerator?

I am not in the least way anti-technology. I challenged you to demonstrate a real medical technology which has dramatically fallen in price; your X-ray example is very poor since it has taken 100 years to achieve the mythical cost savings.

As noted above: LASIK/PRK and cosmetic surgery are 100% elective and thus are a very different market than normal health care.

Even looking at transplants - a technique first successfully performed in 1968 - even disregarding the donor availability issue, the costs of this procedure are still astronomical.

The simple fact is that the bill in Congress is added directly to current expenses. It will cut MediCare, but will add its own costs directly on top of current expenses paid--unless you think that the entire system will change overnight?

Again, you create a straw man to battle. I have clearly stated on many occasions that the present bill is a sham. What really needs to happen is for an alternate system for both actuarial management as well as health care delivery.

Thus your point is completely wasted on a false target. I note yet again that other nations have both public and private systems yet pay fractions of what Americans do.

Also, you really consider the results of the US to be mediocre at best? I'll chalk that up to rhetorical flourish unless you repeat it. The majority of world R&D is financed and performed in the US, and the results speak for themselves. Granted, I think seven different cures for erectile dysfunction is a bit much, but you can't deny the march of technology and its positive impact on health care.

American's health is very much mediocre. No matter how you put it - the reality is that longevity, child mortality, quality of life, and a host of other statistics show that Americans are at best mediocrely healthy compared to other 1st and 2nd world nations.

As for R & D - perhaps you should actually acquaint yourself with the numbers. You might find that outside of the US government, the amount of R & D spent by health insurance companies is... not quite zero but close. The R & D spent by drug companies is dwarfed by the marketing and sales spending by drug companies.

So again, how does overall health care R & D have anything to do with the spending Americans put towards health care?

And why is the government fine for R & D on health care but not fine for providing it?

So I'd suggest you actually go and look at some real numbers as opposed to the way things ought to be according to Libertarian wishful thinking.

let anyone buy any insurance they want to.

Let any insurance company offer any product they want to.

These are already in existence.

Get rid of employer deductibility of health care.

Let people deduct their entire insurance premiums and all medical expenses from their taxable income

The former is definitely a problem. The latter isn't necessarily a solution by itself.

Assign risky individuals to insurance companies on a mandatory basis in proportion to that insurance company's market share

This is in direct conflict with the idea of 'free markets'. How can an insurance company be prohibited from denying coverage or a claim if the market is truly 'free'?

Get rid of Medicare and Medicaid completely

As much as this may be desired, it is equally impossible. Even disregarding the voting power of those who are already on Medicare or will be soon, there is the actuarial issue of how those who have paid into the system are to recoup their investment.

If people can't afford medical care, then give them money to pay for their medical care.

Isn't that what Medicare and Medicaid are already doing? That doesn't seem to be working terribly well.

Stop treating people who are indigent at hospital emergency rooms. This creates enormous costs by socializing risk and making it possible for people to rationally self insure.

This sounds nice, but as I've noted before - now you're asking doctors to be the arbiters of giving care. Medical professionals don't sign up for that; just as many/most doctors don't know anything about the actual financial aspects of their work, so too do most doctors not want to be put in the position of deciding who gets treatment or not.

Deregulate medical care so people can go to anyone they want, MD or not, and deduct the entire expense. Remove licensing and guild barriers to health care.

So what happens when the quacks end up hurting gullible and desperate patients? Again, a libertarian fantasy.

[Ghent12]

Re: Goodbye to US HealthCare?

As for R & D - perhaps you should actually acquaint yourself with the numbers. You might find that outside of the US government, the amount of R & D spent by health insurance companies is... not quite zero but close. The R & D spent by drug companies is dwarfed by the marketing and sales spending by drug companies.

So again, how does overall health care R & D have anything to do with the spending Americans put towards health care?

And why is the government fine for R & D on health care but not fine for providing it?

So I'd suggest you actually go and look at some real numbers as opposed to the way things ought to be according to Libertarian wishful thinking.

I'd like to make a quick reply to this while I have time, and reply to the rest later.

1) The differential between research R&D and advertising means exactly nothing. It has no relevance whatsoever to this discussion.

2) Of the major drug companies in the world, about half are in the US with a mostly even spread of research R&D. Oh wait, sorry, I'm supposed to be the guy that didn't look at the numbers before posting. Oops, I forgot to follow your protocol before the post you quoted--I did look, and do understand the numbers. I guess tens of billions means nothing nowadays...

3) Health insurance companies are not in the business of providing health care or making meaningful, valuable contributions to it. How many times must we agree on this point before you realize we are saying the same thing? It is expected that their R&D would be essentially zero, and that, much like the differential between R&D and advertising, is an irrelevant point you brought up.

[reallife]

Re: Goodbye to US HealthCare?

Time out everyone. Tit for tat arguments are boring and not very enlightening.

[grapejelly]

Re: Goodbye to US HealthCare?

The problem with US healtchare is simple low point of purchase costs with zero price discovery drives up demand. Make people pay and be able to negotiate prices between providers as well as be responsible for a part of the bill (according to means) and you will see costs come down.

Exactly. So obvious. As is the fact that REAL competition forces prices down. It isn't "profits" that are driving costs up, it is consumers buying and not paying for what they are buying. A sure recipe for out of control costs.

[Roughneck]

Re: Goodbye to US HealthCare?

Perhaps we should examine the governments motivation for "health care reform". The government is facing unfunded liabilities for it's current healthcare entitlements to the tune of about $80 trillion dollars. So in response to this the governments answer is to create another entitlement program expanding coverage to more people? No, the real reason(and this is why the public option is a must for them) is because when the government is the sole provider of health care they can decide how much providers will be paid AND what healthcare treatment we minions are "entitled" to. This and future tax increases are the only way they can begin to pay off on the promises they have currently made.

In order to reduce costs in healthcare you have to understand why costs are high and formulate a plan to reduce these costs. The current health care reform does no such thing.

One reason costs are high is because we have a third party payer system. What a doctor or hospital charges is not based on what people can afford to pay or on what ir costs to provide service and make a reasonable profit. It is based on what an insurance company and it's many actuary tables say they can afford and still make money. Rates are negotiated between these parties without respect to actual market conditions.

If an insurance company was not involved my doctor would charge me a fee for his services( say a physical) that was based on his cost to provide the service and also what cost the market will bear(what the consumer can afford or will pay) for his service.

My idea for reform would be for individuals to pay for basic health care out of pocket.Doctor visits,er visits etc. Wouldn't you rather pay for sevices you actually receive than pay high taxes for services you don't use?
Then, you would have a mutual(not for profit, other than operating expenses) company to insure people against major medical expenses(heart surgery,cancer etc.) the things that would bankrupt the average citizen. Kind of like you do now for property insurance.Under this system(just like life insurance) smokers and people with pre existing conditions would have to pay more. You could also include obesity and lifestyle factors in here as well. The government could subsidize care for the poor and elderly as they do now. You would also place strict limits on medical liabilty and get the lawyers out of the loop. If a doctor screws up enough,you take away his license.

This system would get for profit insurance companies out of the loop,yet it would not be a true government run system.

[Crazyfingers]

Re: Goodbye to US HealthCare?

Nice post Roughneck! I agree with all your solutions, just not your 1st paragraph. We were always going to get health reform. The main goal was for the Democrats to put out something outrageous(public option) that the Republicans could rally against. Then the compromise would be a health bill without the public option, then both parties could claim victory. The lobbyist were working both sides. The healthcare complex was all aboard this train from the beginning. In the end, by LAW, everyone will have to have health insurance. This gives insurance companies millions of new customers and sets a floor on prices through government(taxes payers) subsidies. Its just like the farm subsidies(food stamps). All the American people get in return is no descrimination against pre-existing conditions. THATS IT! And this is where the right wing/left wing noise comes in. IMHO the government is NOT taking over healthcare, they are actually privatizing the whole damn thing!

My other thought on this whole smoke-n-mirrors fiasco: Most people believe Warren Buffet made most of his wealth investing the FLOAT from his insurance companies. Maybe the rush to pass this massive bill that wont take affect for years, is partly to bailout the Health Insurers who invested their float poorly. Seems like half this bill is going straight to the insurance companies and very few of the up front cash going to improving the system.

[c1ue]

Re: Goodbye to US HealthCare?

Of the major drug companies in the world, about half are in the US with a mostly even spread of research R&D. Oh wait, sorry, I'm supposed to be the guy that didn't look at the numbers before posting. Oops, I forgot to follow your protocol before the post you quoted--I did look, and do understand the numbers. I guess tens of billions means nothing nowadays...

Yes, those drug companies you use as examples: clearly you did not read the post I put up from the former editor-in-chief of the New England Journal of Medicine:

http://www.itulip.com/forums/showthread.php?t=12464

Of the 78 drugs approved by the Food and Drug Administration in 2002 (the FDA has to approve a drug before it can be sold; every year it approves roughly 75 drugs) only 17 actually contained new active ingredients, and only seven of those were classified by the FDA as likely to be improvements over drugs already on the market.

...

An internal National Institutes of Health (NIH) document showed that only one of the 17 key research papers that led to the five top selling drugs in 1995 came from the company that sold the drug.

...

By their own figures, in 2002, when profits were 17 percent of sales, the top 10 American drug companies spent only 14 percent of sales on research and development and a whopping 31 percent, more than twice as much, on marketing and administration, the lion's share of which went to marketing.

So clearly you did NOT look at the numbers.

Innovation is NOT in being promoted by the big drug companies. The greatest majority of research comes from universities, the next from small companies which are also often spun out of universities.

Spending does NOT equal productivity. The US health care system in general is a gigantic example of that.

And your point is equally stupid: that half of the drug companies are not in the US is proof that the US system works?

Is that not the exact opposite - that drug companies can exist anywhere whether 'free market' or 'socialist'?

[Ghent12]

Re: Goodbye to US HealthCare?

Yes, those drug companies you use as examples: clearly you did not read the post I put up from the former editor-in-chief of the New England Journal of Medicine:

http://www.itulip.com/forums/showthread.php?t=12464



So clearly you did NOT look at the numbers.

Innovation is NOT in being promoted by the big drug companies. The greatest majority of research comes from universities, the next from small companies which are also often spun out of universities.

Spending does NOT equal productivity. The US health care system in general is a gigantic example of that.

And your point is equally stupid: that half of the drug companies are not in the US is proof that the US system works?

Is that not the exact opposite - that drug companies can exist anywhere whether 'free market' or 'socialist'?

Innovation is NOT being promoted by the big drug companies? Alright, I think we're done here. You are demonstrably wrong. Perhaps you think you are being gouged by the drug companies or whatever? Regardless of your motives, your inability to see the importance of the facts and your confused correlation seems to show a more emotional response to this rhetoric than a logical one. With that, and your perpetually added heat, I will no longer be your fellow participant in this fruitless discussion, made an emotional diatribe by you.