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(RealClearPolitics)   Some Doctors in Oklahoma came up with a genius idea. Why not let free markets and open pricing decide medical care. Surprisingly it has led to better care, lower costs and it isn't done in a back alley and no one is fed dog food   (realclearpolitics.com) divider line 192
    More: Cool, dog food, free markets, pricing, anesthesiologists, health cares  
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13411 clicks; posted to Main » on 18 Nov 2012 at 2:55 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-11-18 02:45:39 PM
$o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers
 
2012-11-18 02:56:50 PM
They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.
 
2012-11-18 02:57:33 PM

WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.


Let them eat cake, Sir.
 
2012-11-18 02:57:54 PM
The problem with averages is that it hides the low point.
 
2012-11-18 02:59:19 PM
Because medical care was always regulated and we have zero history of unregulated medical care in this country as a measure of how this would play out on a larger scale, most notably towards the poor and elderly. Right.
 
2012-11-18 02:59:28 PM
Rich people should harvest the organs of the poor, in order to create jobs.
 
2012-11-18 02:59:40 PM

Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers


A while back "we" deregulated dentist pricing. I came to the surprise of no one but the politicians that prices either stayed where they were or sky-rocketed. That free market experiment has been cancelled.

/You do not expect people to do the honourable thing
//Especially not when talking money
 
2012-11-18 02:59:41 PM
Yeah, what happens if you need the surgery but don't have the cash (either from your own pocket or through insurance)?
 
2012-11-18 03:00:09 PM
Sounds great until greed kicks in, and then puts patients into the situation you see around the country currently.
 
2012-11-18 03:01:02 PM

Bonzo_1116: Yeah, what happens if you need the surgery but don't have the cash (either from your own pocket or through insurance)?


Then you are poor and get your organs harvested. DERP
 
2012-11-18 03:01:35 PM
I say good for them. I haven't been to this location yet, but I will the next time I end up needing something done.
 
2012-11-18 03:01:38 PM

imgod2u: The problem with averages is that it hides the low point.


www.smbc-comics.com
 
ZAZ [TotalFark]
2012-11-18 03:01:46 PM
the company defended its outrageous bills on the grounds that it needs a way to cover losses on services offered free.

Same problem with the lifeguard who asked to ride in the ambulance with the kid he saved and got gouged. The pre-Obama health care system was already largely Marxist, "from each according to his ability, to each according to his need."
 
2012-11-18 03:01:57 PM
"One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits."


It will never work. Those people are indispensible.
 
2012-11-18 03:03:00 PM
What some Doctors may look like
img62.xooimage.com
/Yes, the one on the right isn't the original
 
2012-11-18 03:03:42 PM
Open pricing would be a huge win for consumers. Just think of a travelocity-like site for commodity medical procedures and services. Show the prices for each provider along with a review. Sometimes I can find a way better airfare deal by traveling 90 minutes to the next closest city - would totally do the same for some types of medical services, but that's just me.
 
2012-11-18 03:03:51 PM
The most expensive item on their list is a Penile Prosthesis @ $15,425.00 

I hope it comes with attachments.
 
2012-11-18 03:04:22 PM
"Before we begin your affordable vasectomy, please choose your method of pain management. for $50. We'll give you a bottle of vodka to drink, and a table leg to bite down on. For $15,000 we'll give you some nice narcotic pain killers so you don't feel a thing."
 
2012-11-18 03:05:01 PM

BronyMedic: WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.

Let them eat cake, Sir.


I like the idea of a nationalized healthcare system. I would not be willing to abuse it, though. And that would be one of the biggest problems here in the USA. I had to go to a doctor the other day because of flu/URI. Doc kept asking about insurance. I told him I was paying cash. He was very happy about that (cutting down on paperwork and such) and even gave me some extra attention. So things like that are ok. But when greed takes over the minds of the patients, and the doctors, then the system breaks.
And that is why I hate everyone.
 
2012-11-18 03:05:57 PM
Um, yeah, that incoherent rant brought to you by TheraFLU. Powerful crap.
 
2012-11-18 03:06:32 PM
Next time I am hit by a bus I will carefully choose among competing emergency-care providers for the most cost-effective treatment.

Thanks for the advice, Libertarians!!
 
2012-11-18 03:06:34 PM

UsikFark: The most expensive item on their list is a Penile Prosthesis @ $15,425.00 

I hope it comes with attachments.


Like a hair trigger...?
 
2012-11-18 03:06:59 PM
Outpatient ambulatory surgical centers are also pretty restricted in the level of surgery they can perform. You're not getting anything major done at a facility that can't respond with the resources of an acute care facility in case things go south on the table. I'm guessing that 80-90% of their business is colonoscopies and endoscopies, things that require only moderate sedation.

The one thing that they had right is that the driver in the cost of healthcare is the absolutely obscene profits that major hospitals make. If you really want to make a difference in this trend, have providers go through rate setting commissions just like payers do.
 
2012-11-18 03:07:19 PM

crazytrain: Open pricing would be a huge win for consumers. Just think of a travelocity-like site for commodity medical procedures and services. Show the prices for each provider along with a review. Sometimes I can find a way better airfare deal by traveling 90 minutes to the next closest city - would totally do the same for some types of medical services, but that's just me.


The problem is that most expensive medical services are usually in emergent or urgent care where you don't really have the luxury of shopping around.
This idea works well for elective procedures - not so good for any sort of emergency care, trauma, or expensive chronic treatment such as chemotherapy where the costs will always exceed the means of any average person.
 
2012-11-18 03:07:23 PM
Um, hasn't it been at least half free market? It is in my county at least. Yet everyone runs to the State owned besides the privately owned, no matter how close one is to the privately owned. It's cheaper and it's at least triple the quality.
 
2012-11-18 03:07:25 PM
Because someone somewhere wouldn't be able to afford something.
 
2012-11-18 03:07:45 PM

Vectron: "One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits.to deal with large numbers of poor, chronically ill, patients, because we choose instead to foist them off on public emergency rooms that can't turn them away

"

FTFY
 
2012-11-18 03:08:22 PM
When I had prostate surgery two years ago, my itemized bill included "oral pain medication" and the cost was listed as $500. The only oral pain medication I was offered was Tylenol and I didn't take it, but since it was already out of the bottle it went on my bill. I only stayed one night but the private room's cost was about $1500.

/total bill was about $27k
//insurance paid for 75% of it
 
2012-11-18 03:08:59 PM

fluffy2097: for $50. We'll give you a bottle of vodka to drink, and a table leg to bite down on


More like "$300 surgery-grade" vodka, run through a micron filter and produced under aseptic conditions. Otherwise, you get the meningitis vodka.
 
2012-11-18 03:09:05 PM

BronyMedic: WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.

Let them eat cake, Sir.


Meh, it's not like they won't get what they need. They just have to wait a bit longer for it.
 
2012-11-18 03:10:01 PM

Rising_Zan_Samurai_Gunman: crazytrain: Open pricing would be a huge win for consumers. Just think of a travelocity-like site for commodity medical procedures and services. Show the prices for each provider along with a review. Sometimes I can find a way better airfare deal by traveling 90 minutes to the next closest city - would totally do the same for some types of medical services, but that's just me.

The problem is that most expensive medical services are usually in emergent or urgent care where you don't really have the luxury of shopping around.
This idea works well for elective procedures - not so good for any sort of emergency care, trauma, or expensive chronic treatment such as chemotherapy where the costs will always exceed the means of any average person.


Poor individuals should simply choose not to have cancer if they cannot afford it.
 
2012-11-18 03:10:49 PM
Nothing surprising about it, Subby. An open market is almost always going to provide the consumer with the best service/goods available.
 
2012-11-18 03:12:04 PM

Bonzo_1116: Yeah, what happens if you need the surgery but don't have the cash (either from your own pocket or through insurance)?


You go to the hospital and stiff them when the bill comes, just like everyone else.
 
2012-11-18 03:12:26 PM
Reason is such a funny site. They have some good articles, but seem to go out of their way to prove everything people hate about libertarians being assholes just for the hell of it.

Lance Armstrong Cheated to Win. Why is that Wrong?

and

FEMA: Welfare Masquerading as Disaster Relief
 
2012-11-18 03:12:31 PM

DerAppie: Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers

A while back "we" deregulated dentist pricing. I came to the surprise of no one but the politicians that prices either stayed where they were or sky-rocketed. That free market experiment has been cancelled.

/You do not expect people to do the honourable thing
//Especially not when talking money


Unless they're politicians.

Because you can trust politicians not to be greedier a$$holes than litigation lawyers, and if you don't, then fark YOU they'll send the cops to throw your ass in jail.
 
2012-11-18 03:12:58 PM

Bendal: When I had prostate surgery two years ago, my itemized bill included "oral pain medication" and the cost was listed as $500. The only oral pain medication I was offered was Tylenol and I didn't take it, but since it was already out of the bottle it went on my bill. I only stayed one night but the private room's cost was about $1500.

/total bill was about $27k
//insurance paid for 75% of it


Where? I have you farkied in NC... I've personally spent time at Duke, Wake and Rex; Wake being the worst in quality/monies owed and service, Duke being the best in quality but not service, mostly paid for by insurance; and Rex still being my favorite all around (money-wise, no ripping off, quality, service, etc.)
 
2012-11-18 03:13:54 PM
Health care isn't as expensive if you don't have to use medications.
 
2012-11-18 03:15:19 PM

jaytkay: Next time I am hit by a bus I will carefully choose among competing emergency-care providers for the most cost-effective treatment.

Thanks for the advice, Libertarians!!


Buses don't exist in a Libertarian utopia.
 
2012-11-18 03:16:46 PM
Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.
 
2012-11-18 03:16:54 PM
Wasn't the research that underlies modern medicine underwritten with public money? Aren't the medical schools typically heavily subsidized by the state?
 
2012-11-18 03:17:36 PM
This is a great idea. I just keep saying, make it totally free market. That way when Mitt Romney has a stroke, the neurosurgeon can decide he's not going to show up to work that day for less than $100,000,000. If he doesn't like it, he's more than welcome to spend those precious moments negotiating with one of the less than 3500 neurosurgeons that exist in the country.
 
2012-11-18 03:17:42 PM

Dimensio: Rising_Zan_Samurai_Gunman: crazytrain: Open pricing would be a huge win for consumers. Just think of a travelocity-like site for commodity medical procedures and services. Show the prices for each provider along with a review. Sometimes I can find a way better airfare deal by traveling 90 minutes to the next closest city - would totally do the same for some types of medical services, but that's just me.

The problem is that most expensive medical services are usually in emergent or urgent care where you don't really have the luxury of shopping around.
This idea works well for elective procedures - not so good for any sort of emergency care, trauma, or expensive chronic treatment such as chemotherapy where the costs will always exceed the means of any average person.

Poor individuals should simply choose not to have cancer if they cannot afford it.


Now, for $100, I'll blast you with the malfunctioning microwave for an hour. For $500,000, I'll bring in a certified oncologist and properly calibrated equipment.
 
2012-11-18 03:18:02 PM
"Because private insurance companies or the government generally pick up most of the tab for medical services, patients don't have the normal incentive to seek out value."

Stopped reading at this point, this old and tired idea just will not die no matter how much it doesn't fit the facts or the reasoning skills of someone above the 9th grade.
 
2012-11-18 03:19:49 PM
My last doctor stopped accepting any health insurance from her patients. She just charged a flat $100 for each visit, paid in advance, and if you had a follow-up visit afterwards she would often not charge at all for it. She didn't hesitate to refer me to a specialist or a lab for further tests, and was more than willing to treat multiple ailments in one visit rather than telling me "let's deal with this first, then the other stuff later".

When I asked her why she didn't accept insurance any longer, she said the insurance companies always pressured doctors to see more and more patients each day, and treat only one illness or complaint per visit. She said the goal was to get patient visits with a doctor down to 15 minutes, and keep lab visits to a minimum.

/stopped seeing her when she started pushing herbal treatments and holistic living
//did catch my prostate cancer though
 
2012-11-18 03:21:10 PM

Watching_Epoxy_Cure: Nothing surprising about it, Subby. An open market is almost always going to provide the consumer with the best service/goods available.


Yes, because health care should be just like televisions- Some people can afford real big, expensive ones, some can only afford small cheap ones, and some people can't afford one at all. But, hey, that's life.
 
2012-11-18 03:21:41 PM

Summoner101: UsikFark: The most expensive item on their list is a Penile Prosthesis @ $15,425.00 

I hope it comes with attachments.

Like a hair trigger...?


1) "comes with attachments" is a double entendre I happen to enjoy
2) you just know someone would pay for picatinny rails
 
2012-11-18 03:21:46 PM

jaytkay: Next time I am hit by a bus I will carefully choose among competing emergency-care providers for the most cost-effective treatment.

Thanks for the advice, Libertarians!!


I actually did do this once inside of an ambulance. I said take me to Rex or leave me where I am. They said they were employed by Wake and had to take me there so I told them I'd rather die in the street; we were physically much closer to the hospital that I asked for. Kudos to them, they called the other ambulance service in the city who were not employed by the privatized hospital and took patients to the closest hospital as opposed to the one who... sucks donkey-balls.
 
2012-11-18 03:22:30 PM

Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers


You must not know many asian doctors.
 
2012-11-18 03:22:41 PM
57% what?
 
2012-11-18 03:23:29 PM

Bendal: My last doctor stopped accepting any health insurance from her patients. She just charged a flat $100 for each visit, paid in advance, and if you had a follow-up visit afterwards she would often not charge at all for it. She didn't hesitate to refer me to a specialist or a lab for further tests, and was more than willing to treat multiple ailments in one visit rather than telling me "let's deal with this first, then the other stuff later".

When I asked her why she didn't accept insurance any longer, she said the insurance companies always pressured doctors to see more and more patients each day, and treat only one illness or complaint per visit. She said the goal was to get patient visits with a doctor down to 15 minutes, and keep lab visits to a minimum.

/stopped seeing her when she started pushing herbal treatments and holistic living
//did catch my prostate cancer though


Cool story, bro.
 
2012-11-18 03:24:27 PM

Thisbymaster: "Because private insurance companies or the government generally pick up most of the tab for medical services, patients don't have the normal incentive to seek out value."

Stopped reading at this point, this old and tired idea just will not die no matter how much it doesn't fit the facts or the reasoning skills of someone above the 9th grade.


The perfect time to seek out value is when you're in the middle of a heart attack or stroke. Another good time to seek it out is when there's only one medicine/treatment that can keep you alive.
 
2012-11-18 03:25:18 PM
Other brilliant articles right next to it at Reason.

Lance Armstrong Cheated to Win. Why is that Wrong?
FEMA: Welfare Masquerading as Disaster Relief


fark that.
 
2012-11-18 03:27:41 PM

CapeFearCadaver: Bendal: When I had prostate surgery two years ago, my itemized bill included "oral pain medication" and the cost was listed as $500. The only oral pain medication I was offered was Tylenol and I didn't take it, but since it was already out of the bottle it went on my bill. I only stayed one night but the private room's cost was about $1500.

/total bill was about $27k
//insurance paid for 75% of it

Where? I have you farkied in NC... I've personally spent time at Duke, Wake and Rex; Wake being the worst in quality/monies owed and service, Duke being the best in quality but not service, mostly paid for by insurance; and Rex still being my favorite all around (money-wise, no ripping off, quality, service, etc.)


I had the surgery done at Rex. I was very pleased with the whole process. It was all well handled, everyone took good care of both me and my wife throughout the surgery and recovery, but the items on the bill were a little eye-opening. My urologist handled the surgery, not a doctor working at Rex, and I was up and walking around just a few hours after I woke up.

OTOH, when my wife's doctor sent her to Rex's ER for what she suspected was a blood clot in her leg, we went there on her recommendation to get a more specific test quickly. We waited for about 4 hours in the ER before seeing a doctor, who examined her leg and told us "she was wrong, your leg is fine" and sent us home without any tests, medication or anything else. The bill for that ER visit was over $600 for 5 minutes with a staff doctor who did nothing.
 
2012-11-18 03:27:52 PM

UsikFark: The most expensive item on their list is a Penile Prosthesis @ $15,425.00 

I hope it comes with attachments.


randomhoohaas.flyingomelette.com
 
2012-11-18 03:28:43 PM

signaljammer: Wasn't the research that underlies modern medicine underwritten with public money? Aren't the medical schools typically heavily subsidized by the state?


Shhhhhhhut your mouth!
 
2012-11-18 03:29:08 PM

Cuchulane: Outpatient ambulatory surgical centers are also pretty restricted in the level of surgery they can perform. You're not getting anything major done at a facility that can't respond with the resources of an acute care facility in case things go south on the table. I'm guessing that 80-90% of their business is colonoscopies and endoscopies, things that require only moderate sedation.

The one thing that they had right is that the driver in the cost of healthcare is the absolutely obscene profits that major hospitals make. If you really want to make a difference in this trend, have providers go through rate setting commissions just like payers do.


THIS.

If something goes horribly wrong at an ambulatory surgery center, you're getting a ride to the local tertiary care facility either by a ground or Air critical care team.
 
2012-11-18 03:31:13 PM
It's okay for the free market to decide the value of scarce things like yachts. The whole point of a market is to find the fairest way to distrbute scarce goods. If I don't get a yacht, oh well.

Medical care is another story.

1. There needs to be enough to go around.

2. EVERYONE should get it, even if it's free for some people.

Both 1 and 2 make society better for everyone. Applying a tool (the market) where is doesn't belong is nothing more than religious dogma, and it deserves to be cast aside.
 
2012-11-18 03:35:58 PM
Meh; why worry about medical care? We're just going to blow ourselves up anyway. It's only a matter of time.

Either that; or we'll end up in one of these;

Progressive Paradise: where it is ok to censor art and media , because of teh children. And you can't defend yourself.

The authoritarian paradise; 1984, eat your heart out.

The libertarian paradise; bootstraps for your bootstraps

The facist paradise; foreigners and Jews cause all the problems

And, last, but not least Theocracy!

/ let's all sing the doom song
 
2012-11-18 03:37:11 PM

iheartscotch: Meh; why worry about medical care? We're just going to blow ourselves up anyway. It's only a matter of time.

Either that; or we'll end up in one of these;

Progressive Paradise: where it is ok to censor art and media , because of teh children. And you can't defend yourself.

The authoritarian paradise; 1984, eat your heart out.

The libertarian paradise; bootstraps for your bootstraps

The facist paradise; foreigners and Jews cause all the problems

And, last, but not least Theocracy!

/ let's all sing the doom song


Dude. Put down the bong....
 
2012-11-18 03:40:31 PM
Since when did Progressives censor art? Are you thinking of Giuliani's reaction to "Piss Christ"? Citation definitely needed.
 
2012-11-18 03:41:05 PM
It seems like subby forgot one of the most basic princples of a free market - the ability to decide not to purchase the goods at all.

Sorry - medical care doesn't work that way.
 
2012-11-18 03:41:08 PM

WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.


ummm.....wat??
You can't even do that in Alberta where the most likely place to even THINK you can do that would be.
Link

Either you're full of it, or know something I don't, and if it's the latter, please share.
 
2012-11-18 03:41:11 PM

Bonzo_1116: Yeah, what happens if you need the surgery but don't have the cash (either from your own pocket or through insurance)?


It appears you've never heard of private charities and fundraisers. I spend a few hundred dollars on donations for people I know every year.
 
2012-11-18 03:41:38 PM

Dinki: Watching_Epoxy_Cure: Nothing surprising about it, Subby. An open market is almost always going to provide the consumer with the best service/goods available.

Yes, because health care should be just like televisions- Some people can afford real big, expensive ones, some can only afford small cheap ones, and some people can't afford one at all. But, hey, that's life.


Or as I like to say, "No one is too poor to fark off and die".
 
2012-11-18 03:43:06 PM

whistleridge: Vectron: "One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits.to deal with large numbers of poor, chronically ill, patients, because we choose instead to foist them off on public emergency rooms that can't turn them away"

FTFY


Exactly right. Nice that they cater exclusively to patients with money. Find an answer for what to do with people who can't pay.
 
2012-11-18 03:44:57 PM

Bendal: OTOH, when my wife's doctor sent her to Rex's ER for what she suspected was a blood clot in her leg, we went there on her recommendation to get a more specific test quickly. We waited for about 4 hours in the ER before seeing a doctor, who examined her leg and told us "she was wrong, your leg is fine" and sent us home without any tests, medication or anything else. The bill for that ER visit was over $600 for 5 minutes with a staff doctor who did nothing.


Ahhh, yet I'd take that experience with your wife and the suspected blood clot over my suspected blood clot (yes, same thing) experience at Wake. I ended up owing almost $100,000 at Wake for the same damn thing. They almost amputated my leg on two separate occasions when it didn't need amputation. They drew my blood a total of 13 times because of an abnormality in my white-blood cell count (each time the blood is drawn and tested, $350). They didn't bother to open my chart and see that the very first line in all my charts says I was born with a low white-blood cell count. Each and every white blood cell I had at that moment was in my right leg fighting the massive infection, they weren't in my left arm.
We left them with a big FU, went to Rex, they found that I had a massive Baker's Cyst rupture and a bone disease, all treatable without amputation. Ended up getting the care at Rex and surgery at Duke. And only at Duke because it was a very new bone-grafting surgery that only one surgeon in NC knew how to perform at the time. All of Rex & Duke's bills combined didn't reach the amount that Wake tried to charge me for their incompetence.

Excuse me, rant over. VERY happy you got the care for your surgery at Rex, and I'm sorry for your wife's experience there for the possible blood clot... but, it could've been worse, you could've gone to Wake :/
 
2012-11-18 03:45:03 PM

leevis: Bonzo_1116: Yeah, what happens if you need the surgery but don't have the cash (either from your own pocket or through insurance)?

It appears you've never heard of private charities and fundraisers. I spend a few hundred dollars on donations for people I know every year.


All those charities must be why 50,000 people each year in the United States die because they don't have the funding and health insurance to obtain necessary treatment that is not deemed required by COBRA or EMTALA.

It must also be the reason that the Emergency Services system in the United States is being taxed beyond the point of viability by financial insolvency, and being a massive drain on both federal and state Governments which are subsidizing facilities to keep them open.

ERs were never intended for use as primary care physicians. Yet because of the inability of a large portion of the socioeconomically desperate to obtain adequate health insurance, and the EMTALA laws, they are being used as such.
 
2012-11-18 03:45:31 PM
The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

The surgery center doesn't have to deal with any of that so it's disingenuous of them to pretend they've discovered this fantastic new business model that everyone else is too greedy to implement.
 
2012-11-18 03:45:44 PM
For example, both human resources and building maintenance are the responsibility of the head nurse

Sounds like a shiatty place to work, to me. I don't know too many people who go to nursing school so they can change lightbulbs or wash windows. In fact, unless they're paying a substantially higher than market rate for those personnel, it's likely that job satisfaction for those employees is low and they probably have a high turnover rate or low quality workers. Capitalism!
 
2012-11-18 03:45:47 PM

BronyMedic: iheartscotch: Meh; why worry about medical care? We're just going to blow ourselves up anyway. It's only a matter of time.

Either that; or we'll end up in one of these;

Progressive Paradise: where it is ok to censor art and media , because of teh children. And you can't defend yourself.

The authoritarian paradise; 1984, eat your heart out.

The libertarian paradise; bootstraps for your bootstraps

The facist paradise; foreigners and Jews cause all the problems

And, last, but not least Theocracy!

/ let's all sing the doom song

Dude. Put down the bong....


No, no. He's hearting teh Scotch today.
 
2012-11-18 03:47:00 PM

UsikFark: Summoner101: UsikFark: The most expensive item on their list is a Penile Prosthesis @ $15,425.00 

I hope it comes with attachments.

Like a hair trigger...?

1) "comes with attachments" is a double entendre I happen to enjoy
2) you just know someone would pay for picatinny rails


Well, I just bought MINE on eBay for $68.32. It's Chinese crap, sure, but if it breaks, I'll just buy another one.
 
2012-11-18 03:47:33 PM
So, the video shows that a private company A provides the same healthcare service as another private company B, but somehow the fact that private company B is a price gouger and maybe even defrauds the payer, a national healthcare service is bad for you?

It appears that the only story here is that the Integris company is defrauding tax payers by abusing the medical bills, by pulling tricks such as charging nearly $300 for $1.50 medicine, and nearly $30k for surgeries that are performed elsewhere for less than $3k.
 
2012-11-18 03:47:50 PM
So some surgeons picked off the "low hanging fruit" to make a better model? Sounds great.

But what about patients who have conditions that require lengthy overnight stays and supervision? Oh right, these guys wouldn't touch those patients with a ten-foot rectal thermometer.
 
2012-11-18 03:48:32 PM

BronyMedic: iheartscotch: Meh; why worry about medical care? We're just going to blow ourselves up anyway. It's only a matter of time.

Either that; or we'll end up in one of these;

Progressive Paradise: where it is ok to censor art and media , because of teh children. And you can't defend yourself.

The authoritarian paradise; 1984, eat your heart out.

The libertarian paradise; bootstraps for your bootstraps

The facist paradise; foreigners and Jews cause all the problems

And, last, but not least Theocracy!

/ let's all sing the doom song

Dude. Put down the bong....


In the words of Charlton Heston, "I'll put it down when you pry it from my cold, dead hands."

I may have paraphrased that statement

I keed, I keed

On a serious note; it's only a matter of time. Democracy is very fragile and, usually, transitional government type.
 
2012-11-18 03:49:32 PM

OscarTamerz: The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.


OTOH, the reason that EMTALA, the Emergency Medical Treatment and Labor Act exists is because hospitals would turn away people from their doors, without even giving them an exam or lifesaving stabilizing treatment, and either let them die on their doorsteps, or send them across the county to the "poor" hospital, which didn't have either the resources or the staff to care for them.
 
2012-11-18 03:51:27 PM
Want to reduce medical costs? Stop funding the search for the fountain of youth. Average recipient for Medicare spends 100k the last year of their life. Some rationale in treatment is due. No more spending 100k for a 6 month extension of life. Sorry. It is not affordable.
 
2012-11-18 03:53:03 PM

OscarTamerz: Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.


Because everybody NEEDS a Mercedes S and steak and lobster, and sometimes has to make life-or-death decisions about purchasing them.
 
2012-11-18 03:54:18 PM

html_007: I say good for them. I haven't been to this location yet, but I will the next time I end up needing something done.


You back in OKC now?
 
2012-11-18 03:54:35 PM

TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.


I have a better suggestion. Based on open pricing, a national health service tells the patient that they charge a maximum X for a procedure. The kicker is that whatever the patient saves by choosing the cheapest, the patient gets a percentage of the savings. So, the patient now has an incentive to choose the cheapest service he can find, and healthcare providers have to compete to get contracts.
 
2012-11-18 03:54:58 PM

MyRandomName: Want to reduce medical costs? Stop funding the search for the fountain of youth. Average recipient for Medicare spends 100k the last year of their life. Some rationale in treatment is due. No more spending 100k for a 6 month extension of life. Sorry. It is not affordable.


Uh, you want to reduce the cost of healthcare, namely medicare in the United States? Stop smoking.

COPD and Cardiovascular Diseases along with Stroke account for OVER 60% of the costs that Medicare incurs yearly.

/But that'd be socialist communism, or something....
 
2012-11-18 03:55:53 PM

iheartscotch: let's all sing the doom song


Link
 
2012-11-18 03:56:12 PM
So just to clarify, a not-for-profit institution was held up as an example of free market capitalism working? Only from a reason.com reader...
 
2012-11-18 03:56:18 PM

LordOfThePings: OscarTamerz: Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

Because everybody NEEDS a Mercedes S and steak and lobster, and sometimes has to make life-or-death decisions about purchasing them.


Medical care is not an infinite resource. It is astounding that liberals do not understand that. You can't provide every treatment for every person.
 
2012-11-18 03:56:59 PM

jaytkay: Next time I am hit by a bus I will carefully choose among competing emergency-care providers for the most cost-effective treatment.

Thanks for the advice, Libertarians!!


The vast majority of health care spending in this country is not on emergency care. IIRC, it's something like 3 or 4%.
 
2012-11-18 03:57:04 PM

Thisbymaster: Stopped reading at this point, this old and tired idea just will not die no matter how much it doesn't fit the facts or the reasoning skills of someone above the 9th grade.


The kicker is that by biatching about how private insurance companies operate, they are complaining about how the free market operates. So, it appears that their little story only proved that free market isn't the panacea they all believe it is.

Selective bias is a biatch.
 
2012-11-18 03:57:33 PM

PC LOAD LETTER: Because medical care was always regulated and we have zero history of unregulated medical care in this country as a measure of how this would play out on a larger scale, most notably towards the poor and elderly. Right.


Psst, the world is older than you are.
 
2012-11-18 03:58:12 PM

MyRandomName: You can't provide every treatment for every person


So you should not treat them when they are at a cheap stage, but rather let them get decompensated and progressed to the point where an emergency room is the only option?

Or we should let them die in the streets?

I'm trying to figure out what you're going for here?
 
2012-11-18 03:58:57 PM

MyRandomName: You can't provide every treatment for every person.


And yet plenty of countries do just that.
 
2012-11-18 03:58:57 PM

BronyMedic: MyRandomName: Want to reduce medical costs? Stop funding the search for the fountain of youth. Average recipient for Medicare spends 100k the last year of their life. Some rationale in treatment is due. No more spending 100k for a 6 month extension of life. Sorry. It is not affordable.

Uh, you want to reduce the cost of healthcare, namely medicare in the United States? Stop smoking.

COPD and Cardiovascular Diseases along with Stroke account for OVER 60% of the costs that Medicare incurs yearly.

/But that'd be socialist communism, or something....


You could say the same for obesity. Simple, move those who smoke, drink, etc to the back of medical lines. But liberals would still decry the policy. The fact is you can't save every human, or any, from death. Yet liberals put forth policy of all medical treatment for anyone. It is not a rational policy.
 
2012-11-18 03:59:00 PM

OscarTamerz: The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

The surgery center doesn't have to deal with any of that so it's disingenuous of them to pretend they've discovered this fantastic new business model that everyone else is too greedy to implement.


I'm stealing this analogy, but it's more exaggerated than this. Patients can walk into the ER having never paid a dime in federal income tax, having never made any effort whatsoever to care for their personal well being, with an outstanding bill at this single hospital that can stand well north of six figures, and receive unlimited care with top notch facilities for as long as they need it. It would be more akin to demanding demanding a plane from the car dealership while the wreckage of your last one is smoldering within view outside the window because you don't know how to fly it anyway.

Then the normal guy off the street walks into the dealership with a card that says a third party will pay for his new vehicle. Nothing flashy, just has to get him to work. John Doe only has to pay $2000 for his brand new Suburu, while Blue Cross gives the dealership $85,000 for aluminum rims and anti-rust coating.
 
2012-11-18 04:00:39 PM

CapeFearCadaver: Bendal: OTOH, when my wife's doctor sent her to Rex's ER for what she suspected was a blood clot in her leg, we went there on her recommendation to get a more specific test quickly. We waited for about 4 hours in the ER before seeing a doctor, who examined her leg and told us "she was wrong, your leg is fine" and sent us home without any tests, medication or anything else. The bill for that ER visit was over $600 for 5 minutes with a staff doctor who did nothing.

Ahhh, yet I'd take that experience with your wife and the suspected blood clot over my suspected blood clot (yes, same thing) experience at Wake. I ended up owing almost $100,000 at Wake for the same damn thing. They almost amputated my leg on two separate occasions when it didn't need amputation. They drew my blood a total of 13 times because of an abnormality in my white-blood cell count (each time the blood is drawn and tested, $350). They didn't bother to open my chart and see that the very first line in all my charts says I was born with a low white-blood cell count. Each and every white blood cell I had at that moment was in my right leg fighting the massive infection, they weren't in my left arm.
We left them with a big FU, went to Rex, they found that I had a massive Baker's Cyst rupture and a bone disease, all treatable without amputation. Ended up getting the care at Rex and surgery at Duke. And only at Duke because it was a very new bone-grafting surgery that only one surgeon in NC knew how to perform at the time. All of Rex & Duke's bills combined didn't reach the amount that Wake tried to charge me for their incompetence.

Excuse me, rant over. VERY happy you got the care for your surgery at Rex, and I'm sorry for your wife's experience there for the possible blood clot... but, it could've been worse, you could've gone to Wake :/


Heh. The only way I would go to Wake is if I was unconscious and my wife was nowhere near. If I was in a car crash in front of Wake and I was conscious, I would demand to go to Rex before I'd let them take me into Wake. I've heard way too many stories from coworkers, neighbors and friends who went to Wake and developed secondary infections, had long recovery times, and expensive bills.

OTOH, I know a single mom who gave birth at Wake on what was apparently the economy plan. She prepaid the charges, and even had a scheduled C-section, for under $2500. Granted she was back home within 36 hours of her surgery, and I don't know how much Medicare handled, and this was back in 2006, but still.
 
2012-11-18 04:01:38 PM

MyRandomName: Medical care is not an infinite resource. It is astounding that liberals do not understand that. You can't provide every treatment for every person.


Who said, other than you, that medical care was an infinite resource?

If you feel compelled to come up with idiotic ideas to biatch about "liberals" then it is a clear tell that a) you don't know what you are talking about, and b) you feel the need to be right in spite of reality.
 
2012-11-18 04:02:00 PM

scavenger: Rich people should harvest the organs of the poor, in order to create jobs.


... and delicious organ dishes.
 
2012-11-18 04:02:22 PM

BronyMedic: MyRandomName: You can't provide every treatment for every person

So you should not treat them when they are at a cheap stage, but rather let them get decompensated and progressed to the point where an emergency room is the only option?

Or we should let them die in the streets?

I'm trying to figure out what you're going for here?


Simple. Rational care. A solid und of life procedure. Some limits on provided medical care. If people want to pay for the fountain of youth, do so on their own dollar, not the public's. Maintain a national level of base care, not the cover everything medical care. People die. Time to grow up and let people know. If the government is spending 100k a year on a poor person to live 3 or 4 years, it is a shiat investment.
 
2012-11-18 04:02:37 PM

MyRandomName: The fact is you can't save every human, or any, from death. Yet liberals put forth policy of all medical treatment for anyone. It is not a rational policy.


So you should not treat them at a cheap, preventative stage, but rather wait until they are a drain on the national healthcare finances?

You cannot deny life-saving medical treatment to someone. To do so is incredibly unethical, and violates every healthcare provider's oath. People have a right to die with dignity, and as free of pain as possible.

Something tells me that you'd rather them die on the streets if they can't afford out of pocket.
 
2012-11-18 04:03:25 PM

david_gaithersburg: PC LOAD LETTER: Because medical care was always regulated and we have zero history of unregulated medical care in this country as a measure of how this would play out on a larger scale, most notably towards the poor and elderly. Right.

Psst, the world is older than you are.


Oh, you want to go FURTHER back? Sure thing. Shall I get the leeches?
 
2012-11-18 04:03:26 PM

leevis: It appears you've never heard of private charities and fundraisers. I spend a few hundred dollars on donations for people I know every year.


That's right. These idiots believe that socialism is so bad that only private institutions do it right.
 
2012-11-18 04:03:39 PM

MyRandomName: Medical care is not an infinite resource. It is astounding that liberals do not understand that. You can't provide every treatment for every person.


False equivalence somehow is an infinite resource. If we could figure out how to harness it, we'd be golden.
 
2012-11-18 04:04:08 PM

MyRandomName: If the government is spending 100k a year on a poor person to live 3 or 4 years, it is a shiat investment.


Not to that person, or his/her family.

While there are certain diseases, such as Alzheimers and Dementia, that should have limits and mandatory end of life planning, others are curable, and DO have survivors.
 
2012-11-18 04:05:35 PM
There are quite a few problems with healthcare in this country. First is the insurance industry. If you have insurance, you don't care what things cost, so why bother shopping around? I'm guilty of this as well.

Relating to point one, we have doctors who charge $500 for a procedure, of which the insurance company only pays, say $100. The guy with insurance doesn't know any better, and thinks his insurance is a life-saver. The guy walking in off the street uninsured is stuck with that full $500, despite the fact that it's clearly a $100 procedure. "Free market" broken at this point. The intersection between supply and demand occurs behind the scenes, the price of the service is vastly inflated and most people are none the wiser.

Because of the combination of insured not caring about prices, and doctors charging uninsured absurdly inflated rates, we have a system that as a whole, costs significantly more than it should.

2 things would solve this in my mind, either single-payer universal healthcare, which protects previously uninsured people from being essentially exploited and put into debt for having the audacity to be ill, or the complete dissolution of the health insurance industry.

Getting rid of the health insurers would remove the complexity of "is this covered, is this doctor in my network", etc, and I believe that overall prices would plummet, as the vast majority of the population couldn't begin to afford even the basic treatments that they take for granted while insured currently.

Personally, I favor the universal healthcare route, as this method is the least likely to have greed enter into the equation and ruin everything, and at the end of the day, wouldn't be nearly as significant a change to the existing infrastructure of our healthcare industry.

//huh... and I used to be a die-hard conservative as well.
 
2012-11-18 04:05:40 PM

WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.


Unless you're talking about getting an MRI scan at a private clinic, or "ponying up a little extra dough" in the sense of traveling to the USA and paying for treatment there, then this is the the falsest thing I've read today.
 
2012-11-18 04:06:27 PM

WhyteRaven74: And yet plenty of countries do just that.


Yeah. Collectively, they are known as third world countries, or uncivilized hellholes where everyone lives miserably.

Those countries also tend to not have public sanitation and healthy drinking water. Next, malaria will be considered a priviledge for libertarians.
 
2012-11-18 04:06:37 PM

DerAppie: Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers

A while back "we" deregulated dentist pricing. I came to the surprise of no one but the politicians that prices either stayed where they were or sky-rocketed. That free market experiment has been cancelled.

/You do not expect people to do the honourable thing
//Especially not when talking money


Deregulated dental care would by definition include higenists doing cleanings (without a dentist's 2 minute check) for $75 or so, the only reason they can't don't is due to regulations.
 
GBB
2012-11-18 04:06:45 PM

OscarTamerz: The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

The surgery center doesn't have to deal with any of that so it's disingenuous of them to pretend they've discovered this fantastic new business model that everyone else is too greedy to implement.


I think a better analogy would be to imagine how much public transportation would cost a paying customer if the bus had to provide free transportation to anyone that asks. Or how much a flight would be if airlines *had to provide free flights for active and retired military, LEO, Fire/medical personel, anyone claiming "hero" status, last minute bereavement, vicims fleeing domestic violence situations, poor, unemployed looking for a job, or any other reason you can think for not wanting to pay for a flight that isn't vacation related.

*had to provide as opposed to some of the generous offers airlines currently budget for.
 
2012-11-18 04:12:17 PM

Bendal: Heh. The only way I would go to Wake is if I was unconscious and my wife was nowhere near. If I was in a car crash in front of Wake and I was conscious, I would demand to go to Rex before I'd let them take me into Wake. I've heard way too many stories from coworkers, neighbors and friends who went to Wake and developed secondary infections, had long recovery times, and expensive bills.


Smart man... I've thought about getting a tattoo on my chest to something among the lines of: "I'd rather die than go to Wake... 'cause I'd probably end up dead anyways. Take me to Rex or allow me to die in peace on the street. Thanks!" Throw in some birds on either side or something.
 
2012-11-18 04:14:59 PM

TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.


Great. Now what do you do when the costs exceed what gets paid? Because that's what happens with Medicare right now. Why do you think the OTHER insurances are billed higher? To cover the lose on Medicare. Don't believe me? Go ask a doctor why they stop accepting Medicare.
 
GBB
2012-11-18 04:19:32 PM

Treize26: There are quite a few problems with healthcare in this country. First is the insurance industry. If you have insurance, you don't care what things cost, so why bother shopping around? I'm guilty of this as well.

Relating to point one, we have doctors who charge $500 for a procedure, of which the insurance company only pays, say $100. The guy with insurance doesn't know any better, and thinks his insurance is a life-saver. The guy walking in off the street uninsured is stuck with that full $500, despite the fact that it's clearly a $100 procedure. "Free market" broken at this point. The intersection between supply and demand occurs behind the scenes, the price of the service is vastly inflated and most people are none the wiser.

Because of the combination of insured not caring about prices, and doctors charging uninsured absurdly inflated rates, we have a system that as a whole, costs significantly more than it should.

2 things would solve this in my mind, either single-payer universal healthcare, which protects previously uninsured people from being essentially exploited and put into debt for having the audacity to be ill, or the complete dissolution of the health insurance industry.

Getting rid of the health insurers would remove the complexity of "is this covered, is this doctor in my network", etc, and I believe that overall prices would plummet, as the vast majority of the population couldn't begin to afford even the basic treatments that they take for granted while insured currently.

Personally, I favor the universal healthcare route, as this method is the least likely to have greed enter into the equation and ruin everything, and at the end of the day, wouldn't be nearly as significant a change to the existing infrastructure of our healthcare industry.

//huh... and I used to be a die-hard conservative as well.


I think there are many misconceptions and a lot of false leads when it comes to trying to solve our healthcare system.

All costs have been computed with actual costs and a little profit. Collectively, all the prices for procedures are calculated to insure profit for the insurance company and healthcare providers in the network. The insurance company then sells their plans to customers for profit as well. If one tries to look at an individual cost for service, it's always going to look as though someone is getting screwed. And that is simply because you are looking at a very narrow segment of the accounting system. It's not designed to be scrutinized like that.

These Doctors that the article is about have done something that makes sense for their own specialized market. If they decide to expand their operation and NOT franchise it, they would then want to create a home office to coordinate and manage all their locations. Then you would see their prices soar because then they would have administrators, board of directors, 15 executives, and enough secretaries to go around. It would be exactly like the hospital corporation they just left. So, in a sense, the solution is to ban the practice of having hospital corporations and mandate that the entire operation be housed in the same complex. Or, even more simply, "smaller is better".
 
2012-11-18 04:22:58 PM

TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.


Do you even know how expensive an MRI machine is? Or how much it costs to fix it when it is not operating? Do you understand how expensive the cost of labor is to do that surgery? How could a hospital possibly pay multiple medical professionals who must be present at a surgery by only charging $100/hour?

You are clueless. Even non-profit hospitals charge about the same as a for-profit hospital for services...and if you read the article, you would see why. To cover the costs of those without insurance, plus the underpayment of Medicare for services rendered to the elderly.
 
2012-11-18 04:29:49 PM

k1j2b3: Do you even know how expensive an MRI machine is?


MRI machines are expensive but they can be used quite a lot, so the actual cost per use isn't very much.
 
GBB
2012-11-18 04:30:11 PM
I'm not entirely convinced that everyone knows the difference between for-profit and not-for-profit.

The difference is in how investors are paid.
For-profit means that the corporation has the option of distributing profits to investors in the form of dividends. If the business does well, they declare a dividend to be paid to investors out of the profit. Commonly, executives are given stocks or options to buy stocks as a form of compensation. They get paid more if the business does well and their strategy would be more profit driven.

In a not-for-profit, profits must remain in the company and used only for expansion or paying debts. Not-for-profits can not distribute profits to employees or investors. All employees are paid through salaries or wages. Depending on regulations, bonuses may be paid on a contractual basis tied to specific productivity goals.

In either case, profit motive still exists.
 
2012-11-18 04:31:08 PM

k1j2b3: You are clueless.


Speaking as a strictly lay-man who was having to have an MRI at least once a month for about a year... I personally, really could not afford the $1K each time... just saying. I have no dog your fight with whoever, but that shiat is too expensive for the average american who lives salary if not hourly.
 
2012-11-18 04:32:45 PM

GBB: I'm not entirely convinced that everyone knows the difference between for-profit and not-for-profit.

The difference is in how investors are paid.
For-profit means that the corporation has the option of distributing profits to investors in the form of dividends. If the business does well, they declare a dividend to be paid to investors out of the profit. Commonly, executives are given stocks or options to buy stocks as a form of compensation. They get paid more if the business does well and their strategy would be more profit driven.

In a not-for-profit, profits must remain in the company and used only for expansion or paying debts. Not-for-profits can not distribute profits to employees or investors. All employees are paid through salaries or wages. Depending on regulations, bonuses may be paid on a contractual basis tied to specific productivity goals.

In either case, profit motive still exists.


This has got to be one of the most thought out statements I have read on Fark in a long time.
 
2012-11-18 04:34:08 PM

Bendal: did catch my prostate cancer though


OMG, I had no idea this was contagious!
 
2012-11-18 04:37:51 PM
In November 2011 I got hepatits A and went to the emergency room. I was there about four hours.
The total amount for services on the bill was $3,500. But because I had insurance, a magic wand was waived and the total amount paid was around $2,000. Yet according to the knuckleheads at Reason, I'm the problem because I didn't think to negotiate prices for services while I was doubled over in pain.

Facilities specifying their prices up front would be a good step......but from my experience it is clear there are much bigger things causing these problems.
 
2012-11-18 04:39:39 PM

WhyteRaven74: k1j2b3: Do you even know how expensive an MRI machine is?

MRI machines are expensive but they can be used quite a lot, so the actual cost per use isn't very much.


I looked it up. MRI machines cost between $1M and $3M. Do you know how many MRIs you'd have to do to recoup costs if you charged only $500 per MRI? What about smaller hospitals that don't have the demand for a lot of MRIs, but yet need that technology in order to compete? We are talking about a LOT of small-town non-profits who must have these tools available, but who will take years and years to recoup the cost of the machines.
 
2012-11-18 04:40:23 PM

Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers


It's because the AMA has a monopoly on health care in this country.

It also irritates me when people refer to health insurance as "health care." Insurance companies are the other reason hospitals charge so much. So, by all means, let's give the insurance providers more power with Obamacare.
 
2012-11-18 04:44:42 PM

BronyMedic: MyRandomName: You can't provide every treatment for every person

So you should not treat them when they are at a cheap stage, but rather let them get decompensated and progressed to the point where an emergency room is the only option?

Or we should let them die in the streets?


Not in the streets.. my tax dollars pay for those. Can't they die in a ditch instead?
 
2012-11-18 04:45:25 PM
I hate to break to news to you guys but this is likely what's going to happen. To control costs by 2020 virtually everybody will have a health plan that has a 2000/4000 deductible, with the possibility of a pharmacy rider. If you're lucky you might have an employer to reimburse a portion, but more and more people will begin "shopping around" their doctors, and the difference between "in-network" and "out-of-network" will disappear, as you are largely paying out of pocket and being reimbursed from an FSA/HSA. The insurance plan simply needs to be informed of the visit and track it towards the deductible, the health plan only steps really when their is a catastrophic event.

Right now the 2000/4000 is the highest allowed (to be implemented by 2016 or something) but that will likely raise at the insistence of insurance companies to 3000/6000, 5000/10000, etc. Thus, most health care being out of pocket. The premiums are being controlled (price caps), so to even out the back end they will simply push more costs on the front end: the deductible.

Don't expect to be paying copays in 5 years.
 
2012-11-18 04:46:06 PM

k1j2b3: TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.

Do you even know how expensive an MRI machine is? Or how much it costs to fix it when it is not operating? Do you understand how expensive the cost of labor is to do that surgery? How could a hospital possibly pay multiple medical professionals who must be present at a surgery by only charging $100/hour?

You are clueless. Even non-profit hospitals charge about the same as a for-profit hospital for services...and if you read the article, you would see why. To cover the costs of those without insurance, plus the underpayment of Medicare for services rendered to the elderly.


I pretty much pulled those amounts out of my ass. The actual amounts of payout could be determined by a panel that analyzes all of the numbers to find the 'break even' point, I was just throwing up figures as an example, I might as well of said '$twoducks' for a MRI.

Set the costs so that they are the minimum that can sustain service, and operate it as a taxpayer funded single-payer system. Everyone pays in because everyone pays some form of taxes (even if it's just payroll deductions). Well, illegal immigrants don't, so when they show up, treat them, get them healthy, and give them the option of starting the naturalization process immediately to become tax-paying citizens, or being sent back where they came from (or Sweden).

Some costs are going to be fixed - a MRI machine costs what it costs, but cost of labor can be negotiated. Find the minimum amount that doctors/surgeons can be paid before they leave the profession or leave the country, and pay that. Costs of drugs could also be greatly reduced. There's no reason that MediCare should have to pay $500 for a dose of medicine that costs $1.50 to produce when most of that profit to the drug company goes straight into a marketing campaign. Make it illegal to advertise prescription drugs, set strict limits on how pharma reps and doctors can interact, and watch drug costs fall. Even better, have drug research be funded for the government with all of the products that develop immediately becoming public domain that can be prescribed and sold for only marginally more than the cost of production.
 
2012-11-18 04:46:08 PM

k1j2b3: I looked it up. MRI machines cost between $1M and $3M. Do you know how many MRIs you'd have to do to recoup costs if you charged only $500 per MRI?


Not hard to calculate: $2000000/$500=4000 scans. At 1 hour per scan, assuming you used the machine for 8 hours/day, it would take 500 days to recoup the cost. Assuming it sits idle on weekends (i.e., not located in a hospital, but in a private radiology office), that's 100 work-weeks -- almost 2 years exactly. That's a very reasonable amount of time, actually.
 
2012-11-18 04:53:25 PM

TuteTibiImperes: k1j2b3: TuteTibiImperes:

Some costs are going to be fixed - a MRI machine costs what it costs, but cost of labor can be negotiated. Find the minimum amount that doctors/surgeons can be paid before they leave the profession or leave the country, and pay that. Costs of drugs could also be greatly reduced. There's no reason that MediCare should have to pay $500 for a dose of medicine that costs $1.50 to produce when most of that profit to the drug company goes straight into a marketing campaign. Make it illegal to advertise prescription drugs, set strict limits on how pharma reps and doctors can interact, and watch drug costs fall. Even better, have drug research be funded for the government with all of the products that develop immediately becoming public domain that can be prescribed and sold for only marginally more than the cost of production..


The only thing in that statement that I 100% agree with in terms of controlling costs. I would say, for prescription only medication as well. Let them advertise OTC to their hearts content.
 
2012-11-18 04:56:49 PM

BronyMedic: WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.

Let them eat cake, Sir.


hey Bro, answer your e-mail, kthx
 
2012-11-18 04:57:02 PM

jshine: k1j2b3: I looked it up. MRI machines cost between $1M and $3M. Do you know how many MRIs you'd have to do to recoup costs if you charged only $500 per MRI?

Not hard to calculate: $2000000/$500=4000 scans. At 1 hour per scan, assuming you used the machine for 8 hours/day, it would take 500 days to recoup the cost. Assuming it sits idle on weekends (i.e., not located in a hospital, but in a private radiology office), that's 100 work-weeks -- almost 2 years exactly. That's a very reasonable amount of time, actually.


Oh great... here comes another libtard with his "math" to try to make his point.

Why is it so hard for you libs to understand that no country can provide free healthcare for its citizens. It's impossible. That's why it's never been tried.
And don't start with the "They do it in Canada"... that's complete bullshiat... everyone knows that Canada isn't even a real place.
 
2012-11-18 04:58:39 PM

jshine: Not hard to calculate: $2000000/$500=4000 scans. At 1 hour per scan, assuming you used the machine for 8 hours/day, it would take 500 days to recoup the cost. Assuming it sits idle on weekends (i.e., not located in a hospital, but in a private radiology office), that's 100 work-weeks -- almost 2 years exactly. That's a very reasonable amount of time, actually.


I knew a sales guy for some kind of scan machine (MRI, Cat Scan, I dont know exactly) and that's exactly how he sold it. The company sold them with interest free financing so the revenue matched the monthly payment, after about 2 years it was pure profit to the Hospital. Said it was the easiest sale he ever did. That was some years ago though.
 
2012-11-18 05:01:38 PM

jshine: k1j2b3: I looked it up. MRI machines cost between $1M and $3M. Do you know how many MRIs you'd have to do to recoup costs if you charged only $500 per MRI?

Not hard to calculate: $2000000/$500=4000 scans. At 1 hour per scan, assuming you used the machine for 8 hours/day, it would take 500 days to recoup the cost. Assuming it sits idle on weekends (i.e., not located in a hospital, but in a private radiology office), that's 100 work-weeks -- almost 2 years exactly. That's a very reasonable amount of time, actually.


You're right, it's just like how the total cost of a car is MSRP+10 years of gas and tires.
 
2012-11-18 05:02:29 PM

maggoo: WhyteRaven74: And yet plenty of countries do just that.

Yeah. Collectively, they are known as third world countries, or uncivilized hellholes where everyone lives miserably.

Those countries also tend to not have public sanitation and healthy drinking water. Next, malaria will be considered a priviledge for libertarians.


Sure, countries like the United Kingdom, Iceland, France, Canada, Germany.... Incidentally, most of them have higher life expectancies and quality of life than the US, but that couldn't possibly have any relationship, right? The rest of the first world manages to provide all their citizens with lifesaving care and the basic necessities for survival, but we couldn't do that here because it would Commi-nism and it might cost some poor millionaire a few extra dollars on his tax returns, so the best idea is to let the people who can't pay whatever the "free market" decides they can charge die.
 
2012-11-18 05:05:45 PM

ChuDogg: I knew a sales guy for some kind of scan machine (MRI, Cat Scan, I dont know exactly) and that's exactly how he sold it. The company sold them with interest free financing so the revenue matched the monthly payment, after about 2 years it was pure profit to the Hospital. Said it was the easiest sale he ever did. That was some years ago though.


The Feds reduced the reimbursement rate significantly in 2006 as part of the Deficit Reduction Act of 2005.
 
2012-11-18 05:06:16 PM

TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.


Medicare/Medicaid rates are laughable and in their current state would make many practices run into bankruptcy. Driving down compensation of physicians (a small slice of the overall pie when you look at the numbers) is guaranteed to drive the talent out in droves.
 
2012-11-18 05:08:01 PM

Doom MD: TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.

Medicare/Medicaid rates are laughable and in their current state would make many practices run into bankruptcy. Driving down compensation of physicians (a small slice of the overall pie when you look at the numbers) is guaranteed to drive the talent out in droves.

^THIS^
 
2012-11-18 05:10:54 PM
Does the surgery center cover traumas, which are often uninsured?

Does the surgery center have an ER, that has to take on all patients and care for them regardless of their ability to pay?

Does the surgery center have to have staff in-house to cover trauma, airway, codes, and other emergencies?

Does the surgery center perform complex vascular procedures with patients with lots of comorbidities that often spend days in the ICU afterward?

Does the surgery center accept lower medicare and medicaid payments?

I will agree that all hospitals could stand to improve their efficiency. I will tell you that the hospital I work at absolutely fails in our ability to get one patient out of the room and get the anesthesia/surgery started on the next one.

But to compare the cost structures of a surgery center vs a large hospital, perhaps a level 1 trauma center is incredibly misleading. What's even more misleading is the idea that the business model of the surgery center is the result of libertarianism vs the other hospital being the result of Obamacare. This is a shameful, misleading POS hit-piece that aims to blame the inefficiencies of a large hospital on a piece of legislation that has NOT TAKEN EFFECT YET.

Moreover, if you want that hospital to improve efficiency, how about not making them provide services for free? So what if everybody that comes into the ER is suddenly insured? What if everybody who comes into the trauma bay and gets an emergency thoracotomy with 30 units of blood transfused and a two-week ICU stay is suddenly insured? What if you suddenly don't have to pass on the cost of that surgery to the guy getting a carpal tunnel release?

Please, Republicans on this thread, read that paragraph above and think about it. If everybody is insured, then suddenly a good size of the costs the average hospital usually has to either eat or pass on to the patients and insurers who can pay, suddenly disappear. This is the whole point of Obamacare.

Granted, I hate Obamacare because it was a weak, half-assed measure that doesn't go far enough. I would have settled for a public option. In reality, what we need is some sort of hybrid single payer/private insurance model. Single payer system for all primary care visits and preventive care, individual mandate for emergency and catastrophic care, and then people can perhaps purchase extra insurance if they want to cover non primary, non preventive, non emergency and non catastrophic care like hip surgeries and the like. Hospitals would have a lot less overhead and could charge a lot less as a result, and patients would not be left out in the rain for basic human-right type healthcare, but our country could still demand a bit of boot-strappiness from them if they wanted something more.
 
2012-11-18 05:11:29 PM

Bendal: We waited for about 4 hours in the ER before seeing a doctor, who examined her leg and told us "she was wrong, your leg is fine" and sent us home without any tests, medication or anything else. The bill for that ER visit was over $600 for 5 minutes with a staff doctor who did nothing.


You think that taking up space in their waiting room for 4 hours comes for free??
 
2012-11-18 05:13:49 PM

Doom MD: TuteTibiImperes: Open pricing is a nice step forward, but this still isn't as beneficial as a true single-payer system would be.

Health care should not be a for-profit business.

With a true single payer system it would be easy to control costs, just state in law that all licensed medical facilities must accept MediCare for 100% of all procedures, and accept whatever MediCare pays as 100% fulfillment of the bill. Then, you just set the amount MediCare pays to make services affordable. Set an MRI at $500, fitting a cast at $100, complex surgery at $100/hr, etc, and set the prices MediCare will pay for drugs and that becomes all the pharmaceutical companies can ask.

Everyone is covered, costs are reduced, and hospitals will be forced to become more efficient to stay in business. Salaries for doctors, surgeons, and administrators will likely go down, but it would be for the common good.

Medicare/Medicaid rates are laughable and in their current state would make many practices run into bankruptcy. Driving down compensation of physicians (a small slice of the overall pie when you look at the numbers) is guaranteed to drive the talent out in droves.


What is the big piece of the pie that can be addressed then? Drug costs are part of it I'm sure, and the government needs to take on the pharmaceutical companies to get that in line. Some serious tort reform to limit malpractice liability and help reduce the cost malpractice insurance would also help.
 
2012-11-18 05:16:54 PM
Um...medical care isn't a luxury. It isn't caviar, where the free market can get you the best caviar at the lowest price, but still unaffordable to many. Everyone NEEDS medical care.
 
2012-11-18 05:17:25 PM
They aren't a hospital with an ER, so they aren't required to serve non-paying patients for free.

Not even remotely an apples-to-apples comparison. Instead of comparing them to a hospital, compare them to other private surgery centers.

/Still sounds like a nice place though.
 
2012-11-18 05:19:15 PM

WhyteRaven74: MyRandomName: You can't provide every treatment for every person.

And yet plenty of countries do just that.


And do it better and cheaper than us.
 
2012-11-18 05:29:03 PM

WhippingBoy: They do that here in Canada, too. I can jump to the front of any waiting list just by ponying up a little extra dough.

Some people... poor people... have a problem with this; to me, it's just capitalism in action.


yeah, that's not a free market.
 
2012-11-18 05:30:48 PM

crazytrain: Open pricing would be a huge win for consumers.


Why do _I_ care? My insurance is paying for it. Actually, the way the system currently is, I have every incentive to get the most expensive service possible.
 
2012-11-18 05:32:53 PM
the system we have in place works much, much better than the free market would.

/no it doesn't. it is not even close.
 
2012-11-18 05:32:59 PM
Yet another case of cherrypicking a smaller outlier within an overall model and falsely extrapolating it to mean the entire system would work if it was run the same way.

It's like driving on the shoulder in a traffic jam. If you're the only one doing it, and there are no cops or people on the shoulder to run over, you think you've hit on a great idea and everyone else is stupid for sitting in line. But it won't work if everyone does the same thing.

This is what libertarians don't get about their theories. They are not proven on a macro scale, but they think they're not only proven, but solid economic law. It's one of the biggest knowledge gaps in existence.
 
2012-11-18 05:34:42 PM

CapeFearCadaver: I actually did do this once inside of an ambulance. I said take me to Rex or leave me where I am. They said they were employed by Wake and had to take me there so I told them I'd rather die in the street; we were physically much closer to the hospital that I asked for. Kudos to them, they called the other ambulance service in the city who were not employed by the privatized hospital and took patients to the closest hospital as opposed to the one who... sucks donkey-balls.


Wish I had thought of that when they were transferring my son to another hospital (the one he was born in had no NICU). I now have a $2700 bill for the transport because the ambulance company is 'out of network'. Silly me should have called around and found the in-network guys I guess. It didn't really occur to me at the time, I was more worried about my 1 day old son being unable to breathe.

/Ended up being a collapsed lung
//Full recovery, just a small scar from the chest tube
///10k in various other bills after the insurance paid their part
 
2012-11-18 05:37:35 PM

maggoo: WhyteRaven74: And yet plenty of countries do just that.

Yeah. Collectively, they are known as third world countries, or uncivilized hellholes where everyone lives miserably.

Those countries also tend to not have public sanitation and healthy drinking water. Next, malaria will be considered a priviledge for libertarians.


I'm hoping that was a misguided attempt at sarcasm. Failing that, I'm hoping you just misunderstood what WhyteRaven74 was saying.
 
2012-11-18 05:38:00 PM

The Southern Dandy: WhyteRaven74: MyRandomName: You can't provide every treatment for every person.

And yet plenty of countries do just that.

And do it better and cheaper than us.


B-b-but Norway doesn't have the blacks, and the messicans! Universal healthcare won't work because lazy poor people.
 
2012-11-18 05:42:17 PM
The real concern in the coming years will not be cost as much as availability. As we add 40 million people to the health care rolls and have so many millions of baby boomers aging, there will probably not be enough doctors to do all of the knee and hip replacements that people need. The ACA ("Obamacare") doesn't address this problem. Neither did it address costs, which are much higher in this country with worse outcomes than many countries with socialized medicine.

Still, this is an interesting concept. I suspect medical tourism may play a big role for baby boomers needing treatments that are too pricey or have too long a waiting list in this country.
 
2012-11-18 05:51:59 PM
25.media.tumblr.com

Can't believe I'm the first with this.
 
2012-11-18 05:57:39 PM
Because private insurance companies or the government generally pick up most of the tab for medical services, patients don't have the normal incentive to seek out value.

Uh... this is supposed to be the purpose of insurance companies and government agencies. You see, insurance companies and government agencies are supposed to have specialized knowledge which allows them to assess potential cost based on cost of procedures, complications, likelihood of recovery, additional therapies and treatments, etc., from a host of treatment centers. As well, providers have greater bargaining power to reduce costs before hand. Patients have the incentive to seek out value via the provider but are f*cked due to the expansive and overwhelming nature of potential medical concerns including a myriad of lifestyle indicators, genetic markers, and flatly random occurrences such as accidents which one could never adequately prepare for. And because there are hassles with insurance providers, such as increased premiums or paying out of pocket, for seeking out regular check-ups and early symptoms, the patient puts off preventative treatment of more severe ailments.

When patients have to seek out value, patients are often in emotional states due to personal or familial ailments which necessitate medical care. Otherwise, the value patients seek out is of quality medical care, minimizing complications, etc., not the least immediate cost. The value insurance providers try to create is through denying payments or minimizing immediate cost, backing this with litigious strength.

"It's always been interesting to me," says Dr. Jason Sigmon, "that in any other industry, tons of attention is devoted to making systems more efficient, but in health care that's just completely lost."

Probably because the research background which provides you the equipment, medicines, procedures, and training you yourself have not developed by hand is concerned with efficiency in terms of saving lives and increasing quality of life by reducing complications and length of recovery. Efficiency in medicine and education are entirely different beasts from other areas.

Because bills charged by Integris are paid primarily by insurance companies or the government, the hospital gets away with gouging for its services. ... The bill, which is strictly for the hospital itself and doesn't include Sigmon's or the anesthesiologist's fees, totaled $33,505. When Sigmon performs the same procedure at the Surgery Center, the all-inclusive price is $5,885.

Which means the Surgery Center has patients who are able to afford medical care not paid via insurance companies or government programs? No kidding the costs are lower.
 
2012-11-18 06:09:58 PM
If free market health care works so well why is it being replaced by "Obamacare"?
 
2012-11-18 06:22:44 PM
so is the price of abortions going down in oklahoma?
 
2012-11-18 06:27:01 PM
I'm stunned that no one thought of this 20 years ago...

oh, wait.
 
2012-11-18 06:46:50 PM

dennysgod: If free market health care works so well why is it being replaced by "Obamacare"?


Power and money.

Obamacare was unpopular when it passed, and they said they would need to pass it before we could learn what was in it. Its penalties on employing people have kept the economy screwed up, and it's the biggest tax increase in American history (yet to really be felt by we the people).

BTW, why do you call the current government screwed up system "free market health care"?
 
2012-11-18 06:49:43 PM

Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers


Oh! I get it! DOLLAR SIGNS!

/That's rich!
//Get it? RICH?
 
2012-11-18 07:25:00 PM

Cthulhu_is_my_homeboy: The Southern Dandy: WhyteRaven74: MyRandomName: You can't provide every treatment for every person.

And yet plenty of countries do just that.

And do it better and cheaper than us.

B-b-but Norway doesn't have the blacks, and the messicans! Universal healthcare won't work because lazy poor people.


Out of curiosity, what is Norway's mean average income? Unemployment rate? Do we have comparative data on lifestyle, health, and other factors? Do we have a comparison of overall financial health and average cost of healthcare per capita?

Seems to me that if we're comparing the US and Norway on the basis of healthcare systems, we'd need a lot of data and points of comparison to factor in a host of things to make a true extrapolation of feasibility of their system here in the US.

But, don't let my pointing out that simply saying "well it works in Norway!" Doesn't even begin to cover the vast differences between them and us that might make such a system unfeasible here stop you from shoving a square peg in a round hole.
 
2012-11-18 07:31:00 PM

SpeedingLunatic: Wish I had thought of that


You live and learn....

/glad your baby boy is all better, give him extra hugs for me tonight :)
 
2012-11-18 07:48:45 PM

BronyMedic: OscarTamerz: The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

OTOH, the reason that EMTALA, the Emergency Medical Treatment and Labor Act exists is because hospitals would turn away people from their doors, without even giving them an exam or lifesaving stabilizing treatment, and either let them die on their doorsteps, or send them across the county to the "poor" hospital, which didn't have either the resources or the staff to care for them.


I second that, They aren't coming to the hospital for a lobster dinner, they are coming because they don't want to die. That example is completely off-base. Good trollin though.
 
2012-11-18 07:50:55 PM

The Southern Dandy: Um...medical care isn't a luxury. It isn't caviar, where the free market can get you the best caviar at the lowest price, but still unaffordable to many. Everyone NEEDS medical care.


When did this happen, it certainly hasn't always been the case.
 
2012-11-18 08:03:55 PM
The prices we have now are being set by the free market and the free market has been increasing costs at a rate much larger than the rate of inflation. If you really want to lower cost, you would have a single payer system where they also price everything out. So the drug that cost $1.50 a dose, will be charged as $1.50. This system is exactly what the right and gop do not want.
 
2012-11-18 08:10:25 PM
"One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits."

i1189.photobucket.com
 
2012-11-18 08:12:50 PM
FTFA:

The major cause of exploding U.S. heath care costs is the third-party payer system, a text-book concept in which A buys goods or services from B that are paid for by C. Because private insurance companies or the government generally pick up most of the tab for medical services, patients don't have the normal incentive to seek out value.

Conversely, what this really means is there is all the incentive in the world by doctors and hospitals to gouge the fark out of insurance companies.

FTFY, subby
 
2012-11-18 08:22:42 PM

TuteTibiImperes: Health care should not be a for-profit business.


Too bad. Not only is it a for-profit business, it's a for-political-profit business too. It shouldn't be that either, but it is.

Putting aside the obvious issue that medical training and technology cost a shiat-ton of money...there's something even simpler going on.

People want to have their cake and eat it too, then have more cake - and not get fat or diabetic or impotent. They're willing to spend rather a lot of money on that - preferably somebody else's money, either the insurance company's or the taxpayers'. And that's the whole argument right there. Who pays for anything you can't take care of yourself...or WON'T take care of yourself in the case of the lifestyle diseases that are driving most of our health care costs...becomes either a business decision, a political decision, or some hybrid of both.

Meanwhile, you are NEVER going to hear a politician say that the person most responsible for each American's health care is staring at them in the mirror, and the cause of the bulk of our health care costs is also staring at them in the mirror. And the band plays on.

We make countless dumbass choices in everything from food to drugs to sex to driving, and expect a disembodied somebody else to endlessly pay for it when shiat blows up.

You want single payer to work here? You will need a business and political class with strong traditions of honesty, competence, and care with money - and that's lacking, to understate things. Even more importantly, you need people with strong traditions of good personal choices - meaning they won't burden the system as much as a Fattysmokes McStarchnbooze would here in the States.

Basically we'd need to be someplace like Norway. We've got our work cut out for us.
 
2012-11-18 08:42:42 PM

Gulper Eel: TuteTibiImperes: Health care should not be a for-profit business.

Too bad. Not only is it a for-profit business, it's a for-political-profit business too. It shouldn't be that either, but it is.

Putting aside the obvious issue that medical training and technology cost a shiat-ton of money...there's something even simpler going on.

People want to have their cake and eat it too, then have more cake - and not get fat or diabetic or impotent. They're willing to spend rather a lot of money on that - preferably somebody else's money, either the insurance company's or the taxpayers'. And that's the whole argument right there. Who pays for anything you can't take care of yourself...or WON'T take care of yourself in the case of the lifestyle diseases that are driving most of our health care costs...becomes either a business decision, a political decision, or some hybrid of both.

Meanwhile, you are NEVER going to hear a politician say that the person most responsible for each American's health care is staring at them in the mirror, and the cause of the bulk of our health care costs is also staring at them in the mirror. And the band plays on.

We make countless dumbass choices in everything from food to drugs to sex to driving, and expect a disembodied somebody else to endlessly pay for it when shiat blows up.

You want single payer to work here? You will need a business and political class with strong traditions of honesty, competence, and care with money - and that's lacking, to understate things. Even more importantly, you need people with strong traditions of good personal choices - meaning they won't burden the system as much as a Fattysmokes McStarchnbooze would here in the States.

Basically we'd need to be someplace like Norway. We've got our work cut out for us.


we need to find ways in which we incentivize people. Say for example, if you're a type II diabetic who is overweight and you don't lose weight, your copay for your insuline/glyburide/metformin is twice as much. Likewise, for hypertension, and definitely likewise for smoking. I bet you if we can get people to just take a modicum of responsibility for these three conditions, we could significantly affect our healthcare costs.
 
KIA
2012-11-18 08:46:59 PM
The fundamental problem is that insurance sets a floor for costs. They will always pay "x" so the caregivers will charge "x". There is zero incentive to reduce prices below "x" - although hospitals can find ways to cut corners to boost profits from x. The competitive process is suspended by insurance, so prices never go down. It's sad, really. Still, nice to see free enterprise working around the obstacles.
 
2012-11-18 08:48:49 PM

rugmannm: The real concern in the coming years will not be cost as much as availability. As we add 40 million people to the health care rolls and have so many millions of baby boomers aging, there will probably not be enough doctors to do all of the knee and hip replacements that people need. The ACA ("Obamacare") doesn't address this problem. Neither did it address costs, which are much higher in this country with worse outcomes than many countries with socialized medicine.

Still, this is an interesting concept. I suspect medical tourism may play a big role for baby boomers needing treatments that are too pricey or have too long a waiting list in this country.


orthopedic surgeons don't want more orthopedic surgeons to help do more orthopedic surgeries. They want to do them themselves so they can have more job security, make more money, have a higher status in the hospitals they work at, etc, etc.
 
2012-11-18 08:52:21 PM
Spend some time in an ER and you will quickly find that most of the people on Medicaid are scum or the bastard offspring of scum, And they show up for non emergencies. Six year knee pain that became an emergency on a Saturday night? The girl that came by ambulance because her orthodontic retainer broke and her mother became irate when she was sent out to triage instead of going right to a room. Now the nurse has to triage her and she has to be evaluated by a doctor just so she can hear "we don't fix retainers. Call your orthodontist." And of course her mother demands a taxi voucher so they can get home. Frig them. ERs need to be able to turn people like those two examples away. We need to stop rewarding people that make bad decisions with free or reduced health care while people like me are forced to pay the cost of their bad decisions. We need to start stigmatizing people that are burdens to society.
 
2012-11-18 09:09:34 PM

rga184: we need to find ways in which we incentivize people. Say for example, if you're a type II diabetic who is overweight and you don't lose weight, your copay for your insuline/glyburide/metformin is twice as much. Likewise, for hypertension, and definitely likewise for smoking. I bet you if we can get people to just take a modicum of responsibility for these three conditions, we could significantly affect our healthcare costs.


First thing we do is blow up agriculture subsidies. If we can't do that, base the subsidies on carbs.

.
 
2012-11-18 09:26:26 PM

rga184: Gulper Eel: TuteTibiImperes: Health care should not be a for-profit business.

Too bad. Not only is it a for-profit business, it's a for-political-profit business too. It shouldn't be that either, but it is.

Putting aside the obvious issue that medical training and technology cost a shiat-ton of money...there's something even simpler going on.

People want to have their cake and eat it too, then have more cake - and not get fat or diabetic or impotent. They're willing to spend rather a lot of money on that - preferably somebody else's money, either the insurance company's or the taxpayers'. And that's the whole argument right there. Who pays for anything you can't take care of yourself...or WON'T take care of yourself in the case of the lifestyle diseases that are driving most of our health care costs...becomes either a business decision, a political decision, or some hybrid of both.

Meanwhile, you are NEVER going to hear a politician say that the person most responsible for each American's health care is staring at them in the mirror, and the cause of the bulk of our health care costs is also staring at them in the mirror. And the band plays on.

We make countless dumbass choices in everything from food to drugs to sex to driving, and expect a disembodied somebody else to endlessly pay for it when shiat blows up.

You want single payer to work here? You will need a business and political class with strong traditions of honesty, competence, and care with money - and that's lacking, to understate things. Even more importantly, you need people with strong traditions of good personal choices - meaning they won't burden the system as much as a Fattysmokes McStarchnbooze would here in the States.

Basically we'd need to be someplace like Norway. We've got our work cut out for us.

we need to find ways in which we incentivize people. Say for example, if you're a type II diabetic who is overweight and you don't lose weight, your copay for your insuline/glyburide/metform ...


I get a $250 credit from my healthcare company if I get a yearly check-up, report my numbers, and do one or two other minor things. The great part, other than being severly under-weight from high metabolism, i'm in great shape. So I get credit for being me. Isn't that special?
 
2012-11-18 09:45:25 PM

dennysgod: If free market health care works so well why is it being replaced by "Obamacare"?


We don't have a free market system right now. A free market would be doctors competing on price. Right now most people simply go to whatever doctor takes their insurance.
 
2012-11-18 09:55:49 PM

UseLessHuman: I second that, They aren't coming to the hospital for a lobster dinner, they are coming because they don't want to die. That example is completely off-base. Good trollin though.


Really, because if you don't eat you die right? But if the supermarket is forced to give away steak and lobster to criminal aliens then the price of your mac and cheese and Wonderbread is going to be astronomical.

The dumboshats transferred the costs of medical care onto the backs of everybody's grandmas who go in to get their broken hip fixed and come out with a bill that is higher than the cost of granny's house. The dumboshats make the grannys pay for the criminal aliens' medical care and then they prevent the use of voter ID cards so the criminal aliens vote by almost 3 million to keep them in office through widespread voter fraud. If you aren't willing to defend your right to no taxation without representation then you're worse off than the Boston Tea Party people and right now the criminal aliens have taken the representation from honest voters with the collusion of President Obama.
 
2012-11-18 10:11:41 PM
you know, all you people talking about lowering health care costs by making people healthier have it back asswards.

We want diabetics and smokers and fatties. THEY DIE SOONER.

If everyone lived a healthy lifestyle, we'd start having tons of people living 90-100 years. The long term costs for caring for someone who lives 100 years is higher then the cost of caring for a fatty that dies at 50.
 
2012-11-18 10:24:46 PM

fluffy2097: you know, all you people talking about lowering health care costs by making people healthier have it back asswards.

We want diabetics and smokers and fatties. THEY DIE SOONER.

If everyone lived a healthy lifestyle, we'd start having tons of people living 90-100 years. The long term costs for caring for someone who lives 100 years is higher then the cost of caring for a fatty that dies at 50.


Are we doing "The American Dream (tm)" or not?

I get so confused....
 
2012-11-18 10:28:21 PM

fluffy2097: you know, all you people talking about lowering health care costs by making people healthier have it back asswards.

We want diabetics and smokers and fatties. THEY DIE SOONER.
.


When healthy people die (mo one survived life yet) they tend to be fighters... VERY expensive.
 
2012-11-18 10:46:11 PM

OscarTamerz: The hospitals have to deal with unfunded mandates which say anyone can get free emergent care that shows up on their doorstep by federal law. The federal government doesn't pay a penny for this and healthcare is the only industry affected. Just imagine how much you'd pay for a car or food if every criminal alien that showed up at the dealership or supermarket didn't have to pay for their new S class Mercedes or steak and lobster. It's tantamount to a tax on sick people and the politicians know it and never talk about it.

The surgery center doesn't have to deal with any of that so it's disingenuous of them to pretend they've discovered this fantastic new business model that everyone else is too greedy to implement.


so you're saying we should socialize medicine and that includes undocumented workers

/imokwiththat.jpg
 
2012-11-18 11:02:48 PM
Those guys are going to be farked if the conservatives in congress get their way and manage to pass that abortion bill that requires all surgeons to have surgery privileges in hospital operating rooms in order to do surgery in surgery centers. You can bet that if they have thier own surgery center, they don't have hospital privileges any more.
 
2012-11-18 11:21:06 PM
Health care is too complicated for people to shop around and you usually can't even get a price ahead of time. So the average person is supposed to call around and get the best price, understanding that one place charges less because they use anesthesia drug A but the other place uses anesthesia drug B. What's the difference? Is one safer or did that particular hospital just get a better price on the drug because they buy a larger quantity?

When my husband was in agony and needed an immediate appendectomy, I didn't call around for prices. Crazily enough, he went from the ER to surgery in the same hospital. Is anyone seriously suggesting I should have sat in the emergency room at 1:00 in the morning, calling around to check prices on appendectomies?

Insurance companies have the ability to negotiate prices and they they do negotiate. The original bill for my husband's surgery was ~$40,000. After "insurance discounts" the price was $3000. If we weren't insured, you think we would have been able to negotiate that $40,000 down to $3000?

His company is switching to one of those "we don't pay for anything but it's awesome because now you can have a health savings account and shop around and save money" health plans. We're still getting details, but we're worried, especially since it only pays for a % of prescription drugs, rather than a standard co-pay. And it looks like our out-of-pocket maximum will be ~$18,000.
 
2012-11-19 12:12:06 AM

Phins: Health care is too complicated for people to shop around and you usually can't even get a price ahead of time. So the average person is supposed to call around and get the best price, understanding that one place charges less because they use anesthesia drug A but the other place uses anesthesia drug B. What's the difference? Is one safer or did that particular hospital just get a better price on the drug because they buy a larger quantity?

When my husband was in agony and needed an immediate appendectomy, I didn't call around for prices. Crazily enough, he went from the ER to surgery in the same hospital. Is anyone seriously suggesting I should have sat in the emergency room at 1:00 in the morning, calling around to check prices on appendectomies?

Insurance companies have the ability to negotiate prices and they they do negotiate. The original bill for my husband's surgery was ~$40,000. After "insurance discounts" the price was $3000. If we weren't insured, you think we would have been able to negotiate that $40,000 down to $3000?

His company is switching to one of those "we don't pay for anything but it's awesome because now you can have a health savings account and shop around and save money" health plans. We're still getting details, but we're worried, especially since it only pays for a % of prescription drugs, rather than a standard co-pay. And it looks like our out-of-pocket maximum will be ~$18,000.


HSAs are good plans, what you don't spend on the premium you should be investing in your HAS. I just switched from a copay plan I got for free to an HSA I get 1800 in employer funding (the difference in premium). I have a $3,000 deductible, so there is a narrow window of medium usage where the copay plan is better. Less usage or more usage (catastrophic) the HSA plan works better.

Also I think you are wrong about the out of pocket max, I dont remember the family plans being that high, though I could be wrong.

See my post above. Almost all employer and private health plans will soon have a deductible. It's like this in MA already. Every employer is discussing rolling out an HSA plan or atleast a front end deductible. Even state and municpal plans got hit hard this year, virtually every school is in transition.
 
2012-11-19 12:49:39 AM
Phins: His company is switching to one of those "we don't pay for anything but it's awesome because now you can have a health savings account and shop around and save money" health plans. We're still getting details, but we're worried, especially since it only pays for a % of prescription drugs, rather than a standard co-pay. And it looks like our out-of-pocket maximum will be ~$18,000.

ChuDogg: HSAs are good plans, what you don't spend on the premium you should be investing in your HAS. I just switched from a copay plan I got for free to an HSA I get 1800 in employer funding (the difference in premium). I have a $3,000 deductible, so there is a narrow window of medium usage where the copay plan is better. Less usage or more usage (catastrophic) the HSA plan works better.

Also I think you are wrong about the out of pocket max, I dont remember the family plans being that high, though I could be wrong.

See my post above. Almost all employer and private health plans will soon have a deductible. It's like this in MA already. Every employer is discussing rolling out an HSA plan or atleast a front end deductible. Even state and municpal plans got hit hard this year, virtually every school is in transition.


The plan we've been on has a deductible ($3000). I don't object to that too much. And there were co-pays for dr. visits and prescriptions. But the new plan is so much worse.

The premiums are cheaper and I haven't done all the math. But the basics of the plan are:

• $3000 deductible (for the two of us)

• everything not-preventive (doctors, labs, MRIs, etc.) in network, 80% of UCR after the deductible is met. So it's not 80% of the actual charge, it's 80% of some random, made up amount that they declare it should cost. In my experience, it means they pay 20%-40% of the actual charge. Out of network, it's 50% of UCR after the deductible is met.

• Separate deductibles for in-network and out-of network (so $3000 each)

• For prescriptions, they pay 30% of the cost of a non-generic, after you meet the deductible. If there's no generic available, that's TS (I'm on a medication that has no generic, it's ~$500/month).

• The out-of-pocket max is $9000 but once again, in and out of network are separate, so that's where I got the $18,000.

• Only the amount of the UCR applies to the deductible, not the actual cost.

So it doesn't pay for anything until we meet the $3000 deductible and only a small % of the actual cost will be applied to the deductible. So we don't get much coverage until we've spent $9000 in-network or $9000 out of network.
 
2012-11-19 01:31:23 AM
Phins: Phins: His company is switching to one of those "we don't pay for anything but it's awesome because now you can have a health savings account and shop around and save money" health plans. We're still getting details, but we're worried, especially since it only pays for a % of prescription drugs, rather than a standard co-pay. And it looks like our out-of-pocket maximum will be ~$18,000.

ChuDogg: HSAs are good plans, what you don't spend on the premium you should be investing in your HAS. I just switched from a copay plan I got for free to an HSA I get 1800 in employer funding (the difference in premium). I have a $3,000 deductible, so there is a narrow window of medium usage where the copay plan is better. Less usage or more usage (catastrophic) the HSA plan works better.

Also I think you are wrong about the out of pocket max, I dont remember the family plans being that high, though I could be wrong.

See my post above. Almost all employer and private health plans will soon have a deductible. It's like this in MA already. Every employer is discussing rolling out an HSA plan or atleast a front end deductible. Even state and municpal plans got hit hard this year, virtually every school is in transition.

The plan we've been on has a deductible ($3000). I don't object to that too much. And there were co-pays for dr. visits and prescriptions. But the new plan is so much worse.

The premiums are cheaper and I haven't done all the math. But the basics of the plan are:

• $3000 deductible (for the two of us)

• everything not-preventive (doctors, labs, MRIs, etc.) in network, 80% of UCR after the deductible is met. So it's not 80% of the actual charge, it's 80% of some random, made up amount that they declare it should cost. In my experience, it means they pay 20%-40% of the actual charge. Out of network, it's 50% of UCR after the deductible is met.

• Separate deductibles for in-network and out-of network (so $3000 each)

• For prescriptions, they pay 30% of the cos ...

I live in England. I go to the doctor and they treat me then I go home. All for 6% of GDP as opposed to the US's 15+%. Anybody who supports the current US system is innumerate or evil.
 
2012-11-19 02:02:18 AM
The title is "Oklahoma Doctors vs. Obamacare", but I fail to see why they are actually mutually exclusive.

Obamacare only stipulates that you need to have care, how much care employers need to provide, and provides assistance for people who can't afford it. It doesn't say anything about how much you need to spend on it in terms of specific costs. If doctors and hospitals all around the country did this, they'd simply succeed in driving the cost of health plans down and making Obamacare much cheaper to implement.
More power to em, but lets not pretend like this is some fight between the free market and ObamaSocialismTM.
 
2012-11-19 02:10:33 AM
Phins

So it doesn't pay for anything until we meet the $3000 deductible and only a small % of the actual cost will be applied to the deductible. So we don't get much coverage until we've spent $9000 in-network or $9000 out of network.


Reason #1 sh*t needs to change.

I work as a practice manager. I see a lot of these problems(this thread). I think, personally, Obamacare is a step in the right direction overall, albeit remaining something of a mixed bag. Care costs are indeed completely out of control. First let's look at current/future changes implemented by Obamacare:

Pluses:
No more uninsurable. We have some patients in the high risk pool now, and I can tell you it is something, that is, it's better than nothing, which is what these poor (literally & figuratively) sumbiches had before. This is by far the most significant portion of the legislation, and the most necessary. Also rules regarding dropping people who get sick - sorry, that's what the insurance business is. If you can't compete then we should nationalize your industry.
No more lifetime limits. Lifetime limits were bullshiat policies instituted by smart accountants to try to deal with outliers, like the guy who was born a hemophiliac, got hep c through a dental procedure, AIDS from a blood transfusion, got stable in 2009 but then developed treatable mesothelioma. Yes, there are a few people who have extremely complicated and expensive-to-treat condition, no I don't think we should abandon them.
Transparency increases.
Medicare refunds & gap coverage. Moar coverage for people on fixed incomes. Niiiiiiiiice.
Tax breaks for care increase.
No more federal insurance for Congress. Welcome to the real world, assholes.

Minuses:
Food labeling. When I want a Big Mac because I didn't get laid tonight, I'm not going to count the farking calories.
Requirements to buy a health plan. This is horsesh*t. If you require it you should provide a public option and then it's a tax. Forcing people to buy a private product (especially one as flawed as medical insurance) is unconscionable and morally indefensible. This is especially egregious because of the population it most affects the 20-somethings - the population least likely to need it or use it and most fiscally impacted because of where they are in life. This amounts to a wealth transfer from the healthy to the cost of the system, which is completely f**king broken.
More medicare documentation requirements. The one maxim about bureaucracy you can't escape is that they'll make more damnable paperwork for everyone.
Dr. pay determined by rating, which doesn't exist as a system yet. I put it in minuses because I assure you whatever is put in place will be inferior to Yelp in every way and it'll cost a pile of money to boot.

Mixed bag/too soon to tell:
More generics. This doesn't seem like it can be mandated into existence, but I guess we'll see what happens.
Tax increase on the wealthiest 5-7%.
Taxes on medical devices, pharma companies, insurance companies.
Medium-business requirements. This will help workers, but hurt growth.
Taxes are always mixed bag, although again I do not see why we should not have a public option with all the expense, regulation and taxing going on. It seems that the insurance companies will/have become unnecessary.


In my office, we are happy to provide our fees for services upfront to our patients, and certainly these Oklahoma docs are doing that. Perhaps the doctors also volunteer, like my employer, at a local free clinic. But the problem is too big to address in this manner; our system needs an overhaul the market cannot provide; ultimately whenever you have a product that people need in order to survive, you need either nationalization or intense regulation, otherwise you end up with profit at the expense of human life. Pithy statements about freedom and markets and capitalism don't mean a whole hell of a lot when your child needs an operation you simply can't afford. And evil insurance companies have no interest in the public good - they routinely deny medication in my office to people who without it cannot work, damaging the system one ruined life at a time. I make free use of the Dept of Insurance in my state to force the insurance companies to provide care, which they are legally obligated to do, to the very mother f**kers whose money they rely on to stay in business.

Maybe in someone else's' office, you were told your insurance denied a medication, but unless you have an exclusion in your policy, I will get it for you in mine. 

/some other time you can get me going on big pharma
 
2012-11-19 03:43:18 AM
Came here for the lefties who can't understand the free market. Wasn't disappointed.
 
2012-11-19 03:48:08 AM

fluffy2097: We want diabetics and smokers and fatties. THEY DIE SOONER.

If everyone lived a healthy lifestyle, we'd start having tons of people living 90-100 years. The long term costs for caring for someone who lives 100 years is higher then the cost of caring for a fatty that dies at 50.


Your theory would hold correct if it was 1951, but it's not - 'managing' lifestyle diseases like diabetes is quite lucrative. Somebody diagnosed at 40 can easily be a buyer of diabetes-related drugs, products and services for another 30.

It's already $45 billion for diabetes management every year, just in the Medicare budget.

Maybe they still die sooner, but now they die at 70 instead of 50.
 
2012-11-19 06:27:07 AM

ShivaHVishnu: Came here for the lefties who can't understand the free market. Wasn't disappointed.


Came here for idiots mouthing of about a free market system that they don't understand.
/Wasn't disappointed.
 
2012-11-19 07:17:54 AM
Had a heart ablation a year ago which entailed me spending the night in the hospital. That's it. One night. The bill I got? $87,000 and change. For real. All I can say is that SOMETHING needs to be done differently.
 
2012-11-19 10:24:12 AM

Xploder: Had a heart ablation a year ago which entailed me spending the night in the hospital. That's it. One night. The bill I got? $87,000 and change. For real. All I can say is that SOMETHING needs to be done differently.


THIS.

My general practitioner signed me up to get an MRI with a leading KC hospital. The hospital told me that MY cost up front was $1000, just for the MRI. I asked my Dr for a second option wherein I was directed to a clinic similar to the Oklahoma service provider that just performs these types of scans. My cost up front was a typical co-pay and the total fee for the scan was less than $500.

I can only imagine what the first hospital charges our insurance company once they get their hard-earned $1000 out of their patient. Now explain to me how the US gov't is going to manage our healthcare when they can't even keep a postal delivery service solvent?
 
2012-11-19 11:28:37 AM

NetOwl: It's okay for the free market to decide the value of scarce things like yachts. The whole point of a market is to find the fairest way to distrbute scarce goods. If I don't get a yacht, oh well.

Medical care is another story.


All goods are, essentially, scarce, because human needs/wants are infinite, but there are only finite resources with which to meet them.
 
2012-11-19 12:23:50 PM

kcfarker: Now explain to me how the US gov't is going to manage our healthcare when they can't even keep a postal delivery service solvent?


Seriously? This bullshiat, you're dropping in this thread? If you let people who knew what they were doing run the government, then maybe the government would be able to function. If you elect assholes whose sole goal is to fark the system over until it breaks, then you're going to end up with a broken system. Look at FEMA for a perfect example.
 
2012-11-19 01:08:36 PM

NetOwl: Both 1 and 2 make society better for everyone.


Says who?
 
2012-11-19 02:54:52 PM

phyrkrakr: kcfarker: Now explain to me how the US gov't is going to manage our healthcare when they can't even keep a postal delivery service solvent?

Seriously? This bullshiat, you're dropping in this thread? If you let people who knew what they were doing run the government, then maybe the government would be able to function. If you elect assholes whose sole goal is to fark the system over until it breaks, then you're going to end up with a broken system. Look at FEMA for a perfect example.


I see you're from Missouri.


So I guess we're even then.
 
2012-11-19 03:27:21 PM

Yogimus: fluffy2097: you know, all you people talking about lowering health care costs by making people healthier have it back asswards.

We want diabetics and smokers and fatties. THEY DIE SOONER.
.

When healthy people die (mo one survived life yet) they tend to be fighters... VERY expensive.


Hmm....what about those of us with stage 4 Hodgkin's lymphoma?

Healthcare workers LOVE us!!
 
2012-11-19 04:45:51 PM

lamecomedian:

All goods are, essentially, scarce, because human needs/wants are infinite, but there are only finite resources with which to meet them.


Medical care isn't a good, chuckles. It's a service, and the need for it is limited by disease, injury and infirmity. Unless you're talking about plastic surgery, where the limiting factor tends to be vanity, but I don't see anyone making the case for publicly funded elective surgery.
 
2012-11-19 05:43:54 PM
I'm marking 11/18/2012 when I first saw "Oklahoma" and "genius idea" in the same sentence. Bucket list nearly complete; now, just waiting on "Texas" and "elects black governor" ...
 
2012-11-20 12:50:07 AM

Azlefty: $o the Why ha$en't thi$ taken the Country by $torm?

Sorry but most doctors are greedier A$$holes than litigation lawyers


Damn those pediatricians and their lavish yachts!
 
2012-11-20 07:42:20 PM

Phins: So we don't get much coverage until we've spent $9000 in-network or $9000 out of network.


The two deductibles don't add up. Once you hit $9,000 out of pocket it's covered in full after that. You don't have to go out of network. Depending on your location, most health plans have decent in-network coverage. It's really to dissuade more emotional ties to certain doctors, as those doctors are usually just in-network to a different health plan anyway. YMMV. if you need to go out of network they do include that option, but that should really only be for life-threatening events and you really shopped around.
 
2012-11-21 10:14:30 AM
See? We're not as dumb as you think we are. Now if we could get a voter's information pamphlet like Oregon does, we might actually have a shot at having someone who isn't a stupid asshole representing us...
 
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