What problem?

Oh yeah. Some people don't have something that was never required before the government got involved. OMG PANIC!

To all of you dopes who think that government health care is the answer...be careful what you wish for, you just might get it.

Subby:

the Free Market will solve the problem

By killing them or having them leave the country for better healthcare?

Elvis_Bogart: To all of you dopes who think that government health care is the answer...be careful what you wish for, you just might get it.

You're exactly right. I'm sure that one-third of our country prefers witch doctors and prayer over actual medical coverage.

You're brilliant.

"The huge number of people without health coverage is worse than an epidemic," Ron Pollack, executive director of Families USA

RON POLLACK

There is something fundamentally wrong when people have to sell their houses and / or declare bankruptcy just because they got sick. You anti-universal healthcare shills are blind, greedy assholes.

Elvis_Bogart: To all of you dopes who think that government health care is the answer...be careful what you wish for, you just might get it.

Good. I've lived under Government healthcare, and GUESS WHATm ASSHOLE? The world didn't end. Now go and fark yourself.

Elvis_Bogart: To all of you dopes who think that government health care is the answer...be careful what you wish for, you just might get it.

Yeah, government health care sure has ruined my life, what with no longer having painful day-long stomach cramps or that nagging lower back problem. All this workplace productivity and income-producing, without a massive medical debt looming over my head, is having a horrid effect on my psyche.

I haven't had health insurance in almost 10 years. Guess I deserve to die if I get sick, eh?

dudemanbro: I haven't had health insurance in almost 10 years. Guess I deserve to die if I get sick, eh?

This ... assholes ... except its 8, not 10.

dudemanbro: I haven't had health insurance in almost 10 years. Guess I deserve to die if I get sick, eh?

Debt won't kill you.

RobertBruce: Debt won't kill you.

Really? Ever hear of Lehman Brothers?

You do realize that if everybody was covered by health insurance, the price of medical care would shoot up even faster than it is right now?

Universal medical insurance isn't the answer. In fact, it's actually part of the problem. We allow medical care to operate on the free market, but its prices are subsidized by the health insurance industry. Doctors, hospitals, and medical equipment manufacturers all charge as much as they can -- not what the market would bear if the patients were paying 100% out of pocket -- because in the end the insurance companies will pay for it.

Some of you might ask: "What about the 'customary' rates that insurance companies impose on providers?" The providers simply charge whatever they want to charge, usually well over the negotiated "customary" charges, knowing full well that the insurers will pay at least the "customary" amount. This practice creates a continuously upward pressure on prices and over time the insurance companies incrementally give in and pass the increased costs on to their customers.

Have you ever looked at an itemized hospital bill? Have you ever noticed something wrong with it -- perhaps a line item or two that shouldn't be there -- and tried to warn your insurance company about it? The stock response in a lot of cases is, "Don't worry about it, we've already paid it," or "It would cost us more to audit the bill than it would to just pay it. Don't worry about it -- you're covered!"

It may sound crazy, but the only thing that is keeping the cost of medical care from rising even faster than it is right now is that part of the population that is uninsured. If everybody had insurance, meaning that the amount of the bill was no longer a problem for the patients, there would be nothing -- short of very strict regulation of prices -- to keep the prices from skyrocketing, just as fast as the insurance scheme would allow it to go.

When politicians say, "The system of medical care in this country is broken," this is a big part of what they're talking about. How do you insure everybody without the prices going towards infinity?

RobertBruce: Debt won't kill you.

I'm actually shocked by how stupid of a statement that is.

Fark Me To Tears: You do realize that if everybody was covered by health insurance, the price of medical care would shoot up even faster than it is right now?

Universal medical insurance isn't the answer. In fact, it's actually part of the problem. We allow medical care to operate on the free market, but its prices are subsidized by the health insurance industry. Doctors, hospitals, and medical equipment manufacturers all charge as much as they can -- not what the market would bear if the patients were paying 100% out of pocket -- because in the end the insurance companies will pay for it.

Some of you might ask: "What about the 'customary' rates that insurance companies impose on providers?" The providers simply charge whatever they want to charge, usually well over the negotiated "customary" charges, knowing full well that the insurers will pay at least the "customary" amount. This practice creates a continuously upward pressure on prices and over time the insurance companies incrementally give in and pass the increased costs on to their customers.

Have you ever looked at an itemized hospital bill? Have you ever noticed something wrong with it -- perhaps a line item or two that shouldn't be there -- and tried to warn your insurance company about it? The stock response in a lot of cases is, "Don't worry about it, we've already paid it," or "It would cost us more to audit the bill than it would to just pay it. Don't worry about it -- you're covered!"

It may sound crazy, but the only thing that is keeping the cost of medical care from rising even faster than it is right now is that part of the population that is uninsured. If everybody had insurance, meaning that the amount of the bill was no longer a problem for the patients, there would be nothing -- short of very strict regulation of prices -- to keep the prices from skyrocketing, just as fast as the insurance scheme would allow it to go.

When politicians say, "The system of medical care in this country is broken," this is a big part of what they're talking about. How do you insure everybody without the prices going towards infinity?

soooo in summation

FREE MARKET!!!! WOOOO!!!!

Fark Me To Tears: Some of you might ask: "What about the 'customary' rates that insurance companies impose on providers?" The providers simply charge whatever they want to charge, usually well over the negotiated "customary" charges, knowing full well that the insurers will pay at least the "customary" amount. This practice creates a continuously upward pressure on prices and over time the insurance companies incrementally give in and pass the increased costs on to their customers.

Have you ever looked at an itemized hospital bill? Have you ever noticed something wrong with it -- perhaps a line item or two that shouldn't be there -- and tried to warn your insurance company about it? The stock response in a lot of cases is, "Don't worry about it, we've already paid it," or "It would cost us more to audit the bill than it would to just pay it. Don't worry about it -- you're covered!"

Then your insurance companies are sloppy. With Canada's two largest private health insurers, dentists and private clinic doctors have a love-hate relationship with them, because they've had to cut out the superfluous charges you just brought up. Manulife is maybe one step away from having a stern-faced woman planted in every dental and physiotherapy clinic, poring over the invoice as it is being drawn up.

The answer to your problem lies with proper auditing. We managed to make ours affordable, with the entire Canadian public as its risk pool, and still com in underneath health care dollars spent per capita. You guys have no excuse.

...still come in underneath the US in health care dollars*...

Fark Me To Tears: It may sound crazy, but the only thing that is keeping the cost of medical care from rising even faster than it is right now is that part of the population that is uninsured.

The millions of people who use the emergency room as their primary care provider and can't pay their bill would tend to disagree with you.

Fark Me To Tears: In fact, it's actually part of the problem. We allow medical care to operate on the free market, but its prices are subsidized by the health insurance industry. Doctors, hospitals, and medical equipment manufacturers all charge as much as they can -- not what the market would bear if the patients were paying 100% out of pocket -- because in the end the insurance companies will pay for it.

I have said the same thing about government loans for college education. I got laughed out of the thread. Eh, whatever, eventually people will realize that this is correct. Probably about half an hour after the shiat hits the fan.

GWShenlong05: ...still come in underneath the US in health care dollars*...

But I don't have to go to the same vet that the mounties bring their horse to.

EatHam: GWShenlong05: ...still come in underneath the US in health care dollars*...

But I don't have to go to the same vet that the mounties bring their horse to.

hey they say healthy as a horse for a reason

/idk why

GWShenlong05: ...still come in underneath the US in health care dollars*...

And people wonder why our economy's in the shiatter. It's all about the magical thinking of the Free Marketeers. Yes, Americans really are this stupid.

MorrisBird: Americans really are this stupid.

our education system has been shiat for at least 15 years so this is what we get

/but srsly blame the parents

MorrisBird: And people wonder why our economy's in the shiatter. It's all about the magical thinking of the Free Marketeers

What happened to your generation, exactly? Weren't you guys supposed to put an end to the Red Scare crap with your love and peace and flower power?

GWShenlong05: What happened to your generation, exactly?

This:

GWShenlong05: MorrisBird: And people wonder why our economy's in the shiatter. It's all about the magical thinking of the Free Marketeers

What happened to your generation, exactly? Weren't you guys supposed to put an end to the Red Scare crap with your love and peace and flower power?


"I am the walrus, koo koo kachoo!"

BFD. Nothing like a little fear-mongering to drive home the point that America MUST have socialized medicine. If it said 86.7 million Americans were without insurance for 2 years, that would be a different story.

I was laid off and without insurance for 2 months. COBRA is too expensive to maintain if you're unemployed. I got a new job and medical benefits.

I would venture to guess that a lot of these people were in similar boat. Laid off and without health insurance until they found a job.

If the government wants to fill gaps, why not offer catastrophic medical care for those without insurance (as in you need emergency surgery or a hospital stay). I see no reason to socialize the entire system.

Fark Me To Tears: Universal medical insurance isn't the answer. In fact, it's actually part of the problem. We allow medical care to operate on the free market, but its prices are subsidized by the health insurance industry. Doctors, hospitals, and medical equipment manufacturers all charge as much as they can -- not what the market would bear if the patients were paying 100% out of pocket -- because in the end the insurance companies will pay for it.

This is true, to a point. Your own doctor will charge the insurance one thing, and then re-negotiate with you for a different fee if it's not covered/goes to deductible.

What is not true is giving everyone health insurance would cause an exponential of this effect, since this is not the only reason health insurance is so high. It's like that sign in the dressing room, or a Wal-Mart bathroom. Help us keep our prices low by reporting shoplifters. It's true. Companies factor in profit margins to cover what they think they will lose to theft.

You can see the same effect in berries. Berries spoil quickly, they transport poorly, and often the bulk of what you buy gets ruined before it ever reaches a customers hands. The cost of what you lose due to berries just being berries is factored in, and spread over what you think you will sell. Which is why if you walk into a grocery stole you can buy pounds of apples several times cheaper than berries.

The same is true with healthcare. For every poor, uninsured person who walks in and gives a fake name; and for every perfectly comfortable middle class person who has a heart attack, loses his job and takes bankruptcy because he can't pay his medical bills--for each of those people the hospital and private practice doc has to write off, you get the berry effect. Their medical bills aren't just going to go away, and so you, Mr. Privately Insured, get to pick up the tab. If everyone had insurance, the berry effect would be removed.

RobertBruce: Debt won't kill you.

It's not debt, it's the fact that a number of hospitals--and I'm thinking cancer centers like MD Anderson--won't touch you unless you have "x" dollars up front. That will kill you, and I've known of it happening.

Hospitals will stop treating you if they think you can't pay. Period. And you will die.

GWShenlong05: What happened to your generation, exactly? Weren't you guys supposed to put an end to the Red Scare crap with your love and peace and flower power?

I don't have a clue.

GWShenlong05: What happened to your generation, exactly? Weren't you guys supposed to put an end to the Red Scare crap with your love and peace and flower power?

1985 happened. That's when New Coke was released. And a colossal marketing failure, the sort of ineptitude you'd have to go back to Hitler's invasion of Russia without winter gear to put into adequate scale, actually ended up being good for the company because they were able to "invent" something called Coke "Classic" and practically double their sales.

This was one of the first massive incidents of incompetence and over-reaching greed being rewarded with lots of money. Naturally, it led to greater, bolder, and more spectacular attempts down the road. A chain reaction, if you will, with a string of dots stretching straight through the dot.com and real estate bubbles.

That's my theory, anyway.

slayer199: If the government wants to fill gaps, why not offer catastrophic medical care for those without insurance (as in you need emergency surgery or a hospital stay). I see no reason to socialize the entire system.

Good thing that nobody has suggested anything remotely like socializing the entire system then, eh?

The US already spends more per capita on health care than the UK. The only differnce is that UK citizens get free health care and we get to go bankrupt when our coverage is denied.

/being over 50 is a pre-existing condition
//you little snots just wait and see what happens when your sorry ass gets truly sick

When our local gov't got a measure passed and TAXED us to provide low cost healthcare to the "working poor," the idea flopped. The program remains underenrolled. Why? Because some people choose not sign up. So why force healthcare upon them? I don't know what the answer is, but universal care isn't it.

People don't need health INSURANCE, they need health care.

If we spend more money on preventative care and education, it would eventually pay off in huge dividends, but that will NEVER happen in this country, because we're too stupid and greedy to make a big investment if we don't see immediate change.

Don't believe me? Go to some thread where people are *honestly* complaining that the stimulus package hasn't turned the economy around. There are people who think Obama would have fixed the economy within his first quarter.

Spending $10 million dollars on nutrition education to stop the childhood diabetes epidemic?? That's socialism!! It makes WAY MORE SENSE to let medicade pay for 25 year old fatties who are too sick to work and live in poverty.

No. No. No. The free market relies on concepts like competition, risk/reward, creative destruction and personal responsibility to try and achieve optimal results.

Better to let gov't tell everybody they are entitled to health care so that they can relax and stop trying to help themselves. And if something is a right, there is no reason to be grateful for it. In fact, we should actually resent the rich bastards who will pay for this care. The filthy money people and their grubby obsession with commerce is why your life is crappy in the first place. THEY did this to you, not you, never you.

Elvis_Bogart: To all of you dopes who think that government health care is the answer...be careful what you wish for, you just might get it.

We need a safety net. We need the equivalent of Social Security for healthcare. But, we essentially have that already. SS is the barest minimum for retirement...it is not a retirement plan exactly. And most states provide coverage for people with low or no income...minimum coverage. There are very few gaps for coverage...however, getting the government to provide that insurance coverage to eligible people requires working with a government bureacracy.

There is coverage avaliable for almost everyone if you know the hoops to jump through to get it from the government (state or federal). Its just that the government does a poor job of managing what it already provides. Look at Medicare, and then ask yourself if that is what you want for everyone.

Military or prison. Great health care.

Il Douchey: Better to let gov't tell everybody they are entitled to health care so that they can relax and stop trying to help themselves

So...my boyfriend ,who never saw a doctor until the day he went to bootcamp because his parents failed in every possible way, he should have pulled himself up by his childhood bootstraps and gotten a job after school that provided healthcare?

And when I got laid off at 22, and started waitressing to pay the bills (no healthcare) and a drunk ran me over, I should have had the resulting $20k in medical bills taken out of my tips, right? Because I should have found a better job?

Fark Me To Tears: Universal medical insurance isn't the answer. In fact, it's actually part of the problem. We allow medical care to operate on the free market, but its prices are subsidized by the health insurance industry. Doctors, hospitals, and medical equipment manufacturers all charge as much as they can -- not what the market would bear if the patients were paying 100% out of pocket -- because in the end the insurance companies will pay for it.

Actually, I'm not sure that you really understand how medical billing works.

Doctors, hospitals, etc set a price for a service. This price is artificially high, and usually a multiplicative factor of what their best insurance carrier will pay. Why? Just like yearly budgeting, if you don't collect everything, insurance companies will keep lowering their reimbursement rates.

Medicare is the 800 lb gorilla. They set the reimbursement rates... other insurers are simply based on Medicare (some more, some less). Outside of Plastics, Dermatology, and a few subspecialties like refractive surgery, and in very wealthy areas, a physician who doesn't take Medicare is a dead duck. This sets up a cascade whereby all charges become artificial... reimbursement is dictated by congress via Medicare.

Let's give an example.

I charge $145 for a complete new patient examination. This includes history, review of systems, visual acuity testing, slit lamp examination, dilation, and detailed retinal evaluation. From start to finish it takes approximately 30 minutes.

Medicare reimburses me roughly $95. BCBS is right around $105. United / Aetna / etc are less. Medicaid is a disaster... if I actually get paid by them it is OK, but I'd estimate 1/2 of my claims are rejected, requiring significant staff time and cost to every get paid (if ever, that is).

So, why don't we just charge $105 to everyone for the exam? Well, next year, congress will sit down and say "let's cut back on the payment for this exam"... this will cause a downward cascade.

These numbers aren't egregious. The real problems come in bigger ticket items... MRI's being billed at 10k, reimbursed at $1500. The out of pocket payers get royally screwed on surgical procedures, diagnostics, imaging, and hospitalizations. That's where people start losing their homes, declaring bankruptcy, etc.

In a true free-market, competition would cause pricing at "fair market value"... this would vary wildly depending on saturation. In my town, there are many people who simply can't drive the 30 miles to my closest competitor. Would it be fair for me to just charge whatever I felt like, and actually expect them to pay that? Or should the poor, immobile, elderly, etc just get stuck with what their particular market will bear?

Trust me... in a free market system, prices will go up dramatically. There are very few people who can do what I do, and there are many people who would gladly pay more for my services. Unfortunately, that would even worsen the growing divide between rich and poor in our country.

Some things work better in a collective. Highways, national park services / forests, military, and yes, healthcare. It's coming, let's just figure out the best way to move forward.

BTW... streamline the billing process (I've written extensively here about hiring the CEO of Visa or Amex to explain how to make a billing system work)... you'll save 25% on overhead with that process alone.

alywa: seems to be an opthomologist


Not that this is your fault, but how come my health insurance won't cover the cost of glasses? Now, I'm happy to pay for my contacts, because that's a vanity purchase, but without my glasses I'm basically blind as a bat (-6.25, -5.75). I get a "discount" for glasses, which still puts them near $100 for even the UGLY frames.

How is that appropriate?? I have *good* health care (Harvard Pilgrim). Any other prescription is $5 a month. WTF??

Just have all major interested parties -- Democrats, Republicans (and what the hell, Greens and Libertarians, too), doctors, lawyers, insurance companies, drug companies, the business community, etc -- submit their own plans for universal coverage. Add successful plans from other countries. Then create a commission to come up with the consistent standards by which success and failure of a plan will be decided -- things like cost, longevity, infant mortality, productivity (or days missed from work) -- over a set interval.

Once you have the plans assembled, the commission picked, and the standards set, create the equivalent of the RAND Health Insurance Experiment for the set. If any plan fails interim goals, randomly divide the people in that group among the more successful plans. Once the study is completed, pick the best plan using the criteria decided, and roll it out to the rest of the country.

One problem with rolling out universal anything is that once it is locked in place and a political interest group gets behind it (see AARP and Social Security), it is *very* hard to make any improvements or even absolutely necessary changes, because certain individuals will inevitably do less well under the newer plan even if the great majority of people do better. That's why you also need a process by which the health insurance experiment is an ongoing activity, with new plans designed, new experiments ran, and new versions of more effective and less costly universal health care access moved out to the entire nation, no matter what interest groups say.

In any case, if there is a clear, simple process to test and improve whatever health care plan the United States decides on, perhaps the argument against it will be somewhat less heated.

what_now: alywa: seems to be an opthomologist


Not that this is your fault, but how come my health insurance won't cover the cost of glasses? Now, I'm happy to pay for my contacts, because that's a vanity purchase, but without my glasses I'm basically blind as a bat (-6.25, -5.75). I get a "discount" for glasses, which still puts them near $100 for even the UGLY frames.

How is that appropriate?? I have *good* health care (Harvard Pilgrim). Any other prescription is $5 a month. WTF??

Medical insurance is a funny beast. Apparently eyes and teeth aren't part of the body, unless you have specific vision or dental insurance.

As an ophthalmologist, the vast majority of what I see is medical (glaucoma, diabetic eye disease, cataracts, etc).

I have never understood why BCBS (for example) denies coverage for someone who comes in for an exam because their vision is blurry (fixed with glasses), but will cover someone who comes in for an exam with blurry vision due to dry eyes.

The glasses / contacts issue comes down to whether they are truly "medical devices" or not. I'm not in the optical business (medical and surgical only), but talking to my colleagues, it is a tremendous, albeit profitable, mess.

/Thinks a yearly or biyearly routine exam should be covered by all healthcare plans, whether universal or private. Glaucoma, diabetic eye disease, etc, if undetected, are extremely costly to treat, and lead to decreased productivity, increased dependence on disability programs, etc.

//Same goes for routine dentistry

///Same goes for routine wellness checkups with Primary Care

////Same goes for routine cholesterol and glucose screenings, mammograms in at-risk patients, pap smears, etc... We could save a ton of money and increase overall health through improved early detection, risk management, education, etc

I wonder.... how much of a hospital's budget is taken up by administration, and how much of it is taken up by actual medical practices?

what_now: So...my boyfriend ,who never saw a doctor until the day he went to bootcamp because his parents failed in every possible way, he should have pulled himself up by his childhood bootstraps and gotten a job after school that provided healthcare? And when I got laid off at 22, and started waitressing to pay the bills (no healthcare) and a drunk ran me over, I should have had the resulting $20k in medical bills taken out of my tips, right? Because I should have found a better job?

No. It should be my responsibility. Me, and everyone else posting here should be forced to pay for whatever you need. And if you'd like to have, say, eight special needs bastard babies, well just send the tab to the taxpayers; it's their problem, let them deal with it.

/Seriously, I believe in compassion and charity, but not at gunpoint.

alywa: /Thinks a yearly or biyearly routine exam should be covered by all healthcare plans, whether universal or private. Glaucoma, diabetic eye disease, etc, if undetected, are extremely costly to treat, and lead to decreased productivity, increased dependence on disability programs, etc.

//Same goes for routine dentistry

///Same goes for routine wellness checkups with Primary Care

////Same goes for routine cholesterol and glucose screenings, mammograms in at-risk patients, pap smears, etc... We could save a ton of money and increase overall health through improved early detection, risk management, education, etc

I agree, completely. Prevention and education. I'm not sure why people think we should go on the way we do.

/how the hell are my glasses NOT a medical device??

If I ever lost my job and my health care, I would probably die in my 30s if I didn't move to Canada. There is no way I could control my cholesterol and seizures without meds and they cost way too much for me to buy them without health insurance. On top of that, I have to go for regular checkups and get blood work to make sure the meds are playing nice with my liver.

So, basically, I'm a fan of universal health care.

Il Douchey: No. It should be my responsibility. Me, and everyone else posting here should be forced to pay for whatever you need. And if you'd like to have, say, eight special needs bastard babies, well just send the tab to the taxpayers; it's their problem, let them deal with it.

Don't you already do that for everyone else insured by your health care company?

what_now: he should have pulled himself up by his childhood bootstraps and gotten a job after school that provided healthcare?

Most states already have programs for children with no healthcare. Connecticut has the HUSKY plan.

what_now: I should have had the resulting $20k in medical bills taken out of my tips, right?

No, the drunk should be paying for it, as well as sitting in jail.

Competition works. The free market works. It's not pretty, but nature isn't always pretty and that's what free market is. It's the natural order. The strong survive, the weak do not. And society gets better for it.

We humans work under this wierd idea that natural laws do not apply to us. Especially in economic situations. We would like to keep everything static. It can't happen and it won't happen.

We also work under the impression that 'if it's not working, do it more.' Perfect examples are education (lol throw money at the problem, that'll work) and health care (same thing).

Il Douchey: Me, and everyone else posting here should be forced to pay for whatever you need.

Well, you'll be paying for his health care for the rest of his life. Had you invested more in Florida's education and foster program, he could have gone to college and not been your worry.

Il Douchey: . And if you'd like to have, say, eight special needs bastard babies, well just send the tab to the taxpayers; it's their problem, let them deal with it.

You don't think there's a difference between "I want to get impregnated with 8 embryos" and "I got hit by a car"?

Which one of those things should be covered?

Il Douchey: /Seriously, I believe in compassion and charity, but not at gunpoint.

We live in a society. It's better to have a healthier one.