Why Medicare is going broke -- a personal observation.

[don]

Re: Why Medicare is going broke -- a personal observation.

when simple things like having enough low-tech staff on duty to help keep 'accidents' from happnin to people who cant fend for themselves in a hospital environment, would seem to be a no-brainer

That ain't where the money is, Lek. (Isn't the market doing a marvelous job with our healthcare system . . .)

[lektrode]

Re: Why Medicare is going broke -- a personal observation.

That ain't where the money is, Lek. (Isn't the market doing a marvelous job with our healthcare system . . .)

guess not - but it probably would, if 'the market' were allowed to function ?? - read: we didnt have 3rd-party-payer profit incentives (landing in some very interesting/obscure places) to screw us out of what we're already paying for - ala $1500 'co-pay' on things like CTscans, in my particular case/bitch - after paying em nearly 6grand/year for coverage!??

and then they charge ya 3bux to park in the garage ?? - when i'm quite certain that the GD garage cost a heluva lot more to build, staff, maintain than the CT machine cost to buy/install/operate - esp when CT's are now such an integral part of the diagnosis regimen in such a lot of cases - yeah sure, a CT machine is expensive, but how about surgery avoided?

WE DONT SEE ANY BENEFIT FROM THAT SIDE OF THE EQUATION !??

howz about charging maybe 100 for a CT and 20bux/hour to park in the garage? - that would be a better solution than gouging the hell out of us, the first time we need something other than having our temperature taken and noting how much more we weigh than the last time they saw us...(not intending so sound-off/dump on you, mr don...)

[don]

Re: Why Medicare is going broke -- a personal observation.

Big IF pal. Like if we weren't dominated by multinational oligopolies, I think life might be sweeter . . . .

[Ghent12]

Re: Why Medicare is going broke -- a personal observation.

That ain't where the money is, Lek. (Isn't the market doing a marvelous job with our healthcare system . . .)

The market is behaving as expected given the extraordinary level of constraint and intervention by political forces. If it were freer, resources would be allocated far more efficiently. If it were less free, the resources would be allocated far more along the lines of political demands. As it stands, the healthcare market cannot possibly be considered to be "a free market" by any reasonable person.

[don]

Re: Why Medicare is going broke -- a personal observation.

The market is behaving as expected given the extraordinary level of constraint and intervention by political forces. If it were freer, resources would be allocated far more efficiently. If it were less free, the resources would be allocated far more along the lines of political demands. As it stands, the healthcare market cannot possibly be considered to be "a free market" by any reasonable person.

More of an oligopoly than a free market, with powerful political puppets bought by that oligopoly.

[flintlock]

Re: Why Medicare is going broke -- a personal observation.

Ideally a mix of market incentives and limitations would exist. Its striking the correct balance that is in question. I doubt we would have the quality of care we have today if some inventive person didn't find profit as motive. But a system which strictly limits competition and sets up artificial barriers to entry is not the answer either. A complex issue for sure. Personally, I think we expect a bit too much sometimes from medicine. We have grown to expect every ache and pain to be addressed to the fullest. To feel like we are 21 when we are 65. To take a little blue pill whenever problems (cough) occur. I like to imagine what a person from the 19th century would think of our "crummy" system.

[kduffey]

Re: Why Medicare is going broke -- a personal observation.

It's not an exact comparison but the industry of dentistry is left alone to function as a market much, much more so than the larger medical industry. People actually shop doctors, compare prices, and make decision for treatment and care based on need, cost and more. Dentistry is the one area of medicine that still functions pretty well. I'm sure that'll change as I believe there is an $11b earmark in ObamaCare for some dentistry intervention.

[don]

Re: Why Medicare is going broke -- a personal observation.

It's not an exact comparison but the industry of dentistry is left alone to function as a market much, much more so than the larger medical industry. People actually shop doctors, compare prices, and make decision for treatment and care based on need, cost and more. Dentistry is the one area of medicine that still functions pretty well. I'm sure that'll change as I believe there is an $11b earmark in ObamaCare for some dentistry intervention.

Bad news. We've enjoyed the free market competitiveness and service of dentistry. Can't have that in the land of the free.

[kduffey]

Re: Why Medicare is going broke -- a personal observation.

My father in law is about to retire as a periodontist... his business has suffered in the down economic years since 2008 because his service is somewhat elective. Because most people come out of pocket for all or most of their care, they elect not to have gum surgery in some cases. The market works well. He doesn't complain, he knows it is elective. He's about to retire and believes he's getting out at just the right time.

[lektrode]

Re: Why Medicare is going broke -- a personal observation.

My father in law is about to retire as a periodontist... his business has suffered in the down economic years since 2008 because his service is somewhat elective. Because most people come out of pocket for all or most of their care, they elect not to have gum surgery in some cases. The market works well. He doesn't complain, he knows it is elective. He's about to retire and believes he's getting out at just the right time.

likely from the POV of having to deal with all the changes coming, eh?

my experience on this particular aspect of med care is that the return on 'investment' in periodontal work is actually BETTER than most med/dent services - the ole 'twice annual' cleaning/checkups routine is partly a scam, IMHO - altho not as diligent as i ought to be in the flossing dept, i have found that getting em cleaned/scraped 4x/year results in much better periodontal health - by time i was in my mid30's, was having to get 'root planed' every few years - once i started getting a thorough cleaning every 3mos, havent needed a root plane since (over 10years now) - the gum pockets improved, with much less bleeding tween the cleanings, as well

and yeah, ok = too much infomation, i know....

[lakedaemonian]

Re: Why Medicare is going broke -- a personal observation.

While I know it falls outside the scope of this forum's traditional focus, I think a reasonable argument could be made to include the occasional comment on looking at things from a different perspective.

This forum focuses on trying to invest to preserve and grow capital through an incredible challenging period.

I'd argue one of the very best investments people can make is in preventative healthcare and wellness through wise lifestyle choices.

As the cost of healthcare continues to explode above the inflation rate(and more importantly wage increases) it makes sense to make some smart(er) choices about our lifestyles.

Eat right....stay mentally and physically active...what's the point of having seven figures stashed in Bullion Valut Switzerland if you are allowing your body to deteriorate at a rate far faster than it needs to and relying on pharmaceutical crutches.

Every time I return to the US to visit(4 times in 2012, and at least 30 times in the past decade) I continue to be amazed, disgusted, angry, and frightened by the changes I see with each snapshot visit.

We often discuss here some visible changes in the US that relate to FIRE, civil liberties/freedoms, etc........but probably the most visual change I've noticed(beyond the NYPD HERCULES Teams of militarized police) is the dangerous levels of obesity and extremely common/poor levels of fitness I see in what is now the majority of Americans.

Assuming things don't go incredibly pearshaped and negative and the US can avoid a malignant and dangerous populist totalitarian phase before righting itself I look at what happened in Cuba.

When the Soviet Union cut Cuba loose and cut off the massive economic support/subsidy apron strings and Cuba entered the "special period" deaths attributed to diabetes and heart disease reportedly plummeted when calorie intake crashed by 1/3 in about 5 years.

I'm sure there would be quite a few negative effects as well.....particularly psychological.....but hopefully the US can not only right itself economically, but also wean itself off of this horrific lifestyle trajectory.

And it's not just the US.

Travel from ANYWHERE in Southeast Asia and compare Asian body mass/obesity there to that found in Kuala Lumpur.....and there is a noticeable difference between the two.....funnily enough matched by the whiff of Dunkin' Donuts in the air in KL's airport.

Health is not a choice for some.......but it is for most.

[Ghent12]

Re: Why Medicare is going broke -- a personal observation.

It's not an exact comparison but the industry of dentistry is left alone to function as a market much, much more so than the larger medical industry. People actually shop doctors, compare prices, and make decision for treatment and care based on need, cost and more. Dentistry is the one area of medicine that still functions pretty well. I'm sure that'll change as I believe there is an $11b earmark in ObamaCare for some dentistry intervention.

It's also like that in other medical specialties that are not a part of the "core" of the medical industry. The various plastic surgery practitioners and laser eye clinics speak volumes to what a less constrained market inside health care can do, as well as veterinary care. Yet we're supposed to completely abandon the principle of free markets because of heart attacks and urgent care? That's just asinine fearmongering.

[doom&gloom]

Re: Why Medicare is going broke -- a personal observation.

Never fear, ObamaCare is here!

(*cough* *sputter* *hack*)

[jk]

Re: Why Medicare is going broke -- a personal observation.

every other developed nation manages to provide a reasonable modicum of health care to all of its citizens with less than half the percentage of u.s gdp expended. let's not forget that. and, iirc, they don't do via a free market system except in some countries as a supplementary option. if we cut big pharma profits [e.g. repeal the clause in medicare part d that FORBIDS the gov't from bargaining with the drug companies] and health insurance/hmo profits and health insurance expenditures seeking ways to avoid providing care, instead of providing care, that would be a good start.

i used to think that lousy health stats in the u.s., in spite of all we spend, were just a reflection of having 2 parallel healthcare systems- one for people with money and one for those without. turns out even the insured and well-off in our country have lousy health- likely lifestyle, obesity, etc

[doom&gloom]

Re: Why Medicare is going broke -- a personal observation.

Big pharma BOUGHT Obamacare they way they wanted it. 'nuff said.