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

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.

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.

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!!

Sounds great until greed kicks in, and then puts patients into the situation you see around the country currently.

"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.

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.

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

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.

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....

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

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

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

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.

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.

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.

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.

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.

Since when did Progressives censor art? Are you thinking of Giuliani's reaction to "Piss Christ"? Citation definitely needed.

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

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

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

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

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.

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.

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.

What some Doctors may look like

/Yes, the one on the right isn't the original

"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.

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.

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

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

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.