Friday, March 27, 2009

health care and freedom

And now to Obama' promise to "fix" health care. Of course I'm assuming (rather safely, I think) that it involves that great and glorious promise of Universal Health Care (applause (copious sarcasm (extra parentheses))).

As the plan is not up for vote and ridicule yet, I'm not going to try to envision the inevitable monstrosity. But to discuss the principle I will use, I don't need specifics.

And I'm not going to expound on the natural inefficiency of government-supplied anything. That's a well-worn ideology battle.

Instead, I'll share a little of my fun with modern dentistry (this week was a filling, last week was a tooth pulling), and some harsh reality.

To begin, no matter which way we go, there will be people that won't get treatment and will die. It sucks, but there it is. Whether it's a lack of doctors and services (due to universal health care) or limited access (due to lack of cash), something will take any Utopian scheme and make it not work, thus killing people.

So it comes down to choosing which direction will benefit the most people.

As I've stated previously, the problem with with health care is that we don't pay for it directly. Most of us either rely on employer-supplied insurance or government supplied insurance. In the case of my younglings, it's the latter. I qualify as one of the millions of uninsured, although since my last time at the doctor's was 15 years ago, it's not much of a thing.

Now the dentist is another story, as I have quite shitty teeth, the kind that will be false eventually. Now I did say I had a tooth pulled last week. I had it pulled because it was rotted do the core (I saw the x-ray). I also had it pulled because the other option would be to slap a crown in there (which costs a lot). Instead, I dropped $110 and left with one fewer tooth. In fact, it cost more to drill out a cavity in another tooth (only 7 more cavities to go (this time)).

But, as I quipped in the last post, I was able to go there and whip out the trusty ol' checkbook.

Now here's the point. To collect the money when it's a check or credit card, all a doctor's office has to do is collect the payment, get it to the bank, and they're paid. With insurance, they have to submit forms, then wait for processing, then maybe argue with the insurance company over the price. And if it's the government, then there's always the possibility the government will decide how much a procedure is worth, and pay accordingly.

Which brings me to what happens when medicine is partially socialized (where we are now). Hospitals and doctors have to find ways to make their money. And when there's a lot of receivables while they wrangle with the government and insurance companies, they're going to pad their prices to compensate. And they're going to nickel and dime everything. And jack the prices on everything.

My son does speech therapy (as he's 4 and still not talking worth a tinker's damn) every week at the hospital. And of course, this cost is covered. But I've seen the bill. Now the hospital is going to be offering a summer camp for developmental issues again this year. This is not covered (as in I write a check). Two months of this (a couple hours a week) is cheaper than half an hour of insurance-covered therapy.

Le me repeat that: Two months of summer therapy (16 hours with about a 2-1 ratio of children to therapists) cost less than half an hour of one-on-one therapy that insurance covers.

Now, one of the things that President Obama talked about (and I agreed with) was that the costs of Medicare and Medicaid have to be brought under control. But I can't ever see this happening under a government-run health system. What I can see is no reason not to take the kids in for every sniffle, because the insurance will cover it. Or because the prescriptions are covered if the doctor writes it. Just think about it: What stops you from taking something if you can have it without paying for it (directly)?

So, as for the solutions, there is no easy one. It comes back to personal responsibility, to people paying for their health care again, and to relegating insurance to the purpose it was meant to be: insurance against the catastrophic. And I don't have the answer on how to get back to this. But the alternative...?

(Yeah, I'm leaving that one up there.)

62 comments:

Toad734 said...

"And I'm not going to expound on the natural inefficiency of government-supplied anything."

You mean like the postal service who can send a letter 3000 miles in 3 days for $.42?

A system where anyone can find almost any book they want, take it home for free and have almost any question answered by a Librarian?

The Military, which can fly a robot from hundreds of miles away and shoot a target the size of a shoe box from a mile up in the sky?

The census that can count almost every person in the United States and their socioeconomic status every 10 years?

A school system that however imperfect, has managed to pump out enough people to keep America the wealthiest, most powerful nations in the world for the last 60 years?

The FAA and air traffic control system which lands thousands of planes daily without incident?

The FHWA which built and keeps thousands of miles of US highways open and functional 24/7.

I wish AIG, Bear Stearns and all the private corporations we are bailing out were run so efficiently.

If we could put that efficiency in the health care system we could eliminate the bureaucracy of having 100s of different insurance companies, 1000s of different private practices which is pretty much a 30% decrease in cost due to the elimination of redundancy (which is why corporations merge) overnight with a national health care plan. Not to mention the government being able to set its own prices, you know, what the rest of the world pays for drugs and medications, to the drug companies.

Now, I will admit, the health care plan which was touted on the campaign trail sucked but national health care is the way of the future and the only way to insure everyone gets preventative care and the only way most US corporations such as the Big Three will become competitive again as the auto plants in Germany, UK, Italy, Japan, etc. all operate with not health care expenses.

And as we have seen in recent weeks, maybe when the kids get a little bump on the head, maybe they should be going to the hospital.

The health care system now is set up to profit from sick people. We are customers, if we stay sick, they have more customers. Is Canada or UK, they keep us healthy so we don't spend so much time in the hospital or on medication. Doctors get paid more when they get their patients to loose weight, quit smoking etc.

My brother has personally racked up over $100,000 in hospital and medical bills throughout his life and he has never paid a dime of it back. What if those hospitals were able to collect that debt? What do you think they could do when it comes to your medical bill? Who do you think pays those costs now? You! You already pay for these people: the gang bangers who get shot, the junkies who overdose, the DUI crashes with no insurance,etc.


Over half of all family bankruptcies today are caused by medical bills.

The American public pays 528 billion dollars in health insurance premiums every year.

The insurance industry pays 200 million per year to pay lobbyists to counter things like Universal Health care.

The American healthcare system is the most expensive in the world.

Americans already spend over 2 Trillion dollars, 16% of their GDP or $6,697 per year, on healthcare and that number will only increase over the next couple of decades.

In Canada, they spend 9.7% of their GDP on healthcare for everyone.

More than 30% of US healthcare costs go towards administrative overhead which could be greatly reduced under a single national system.

Sweden, Germany and France all have more doctors per capita than the United States.

There is a nurse shortage in the United States.

For prescription drugs, Americans spend more than 50% more than what is paid by people in other industrialized nations because costs aren't monitored by any oversight.

With private healthcare, Americans have one of the highest infant mortality rates and lowest life expectancy rates in the industrialized world. So much for being pro-life.

With a true nationalized health care system, we would put 810 billion dollars into the hands of consumers and if they were to spend that money it would mean that much more money pumped into the economy and it would actually be taxed generating 56 billion dollars.

Name: Soapboxgod said...

"You mean like the postal service who can send a letter 3000 miles in 3 days for $.42?"

Actually, they really can't. Because, were it actually economically feasible to do so, they wouldn't be so ridiculously in the red as they now are.

What's more, while the fucking jokers up on capitol hill are bashing banks and like and employing their monopoly of force to make certain that said banks and institutions aren't sponsoring events...

The equally incompetent boobs at the USPS were sponsoring a cycling team, the NY Yankees, the NY Giants, the Chicago Bears, and the Tampa Devil Rays.

Of course the obvious question is "Why would an entity who holds a monopoly on first class mail need to sponsor anything???"

Not only have they no competitors for which they need to outmarket, the fact that they spent nearly a Billion dollars in 2002 alone (according to the Inspector General's report) clearly is not quite a testament to this sound fiscal practice of which you advocate Toad.

TAO said...

Ah Toad, mere facts against blind beliefs....you are so overwhelmed and undergunned.

Name: Soapboxgod said...

It would seem that both you and TAO are forgetting one very fundamental and absolutely crucial fact in your reporting of government's ability to provide us with these wonderful aforementioned services.

The greatness of these public endeavors would have ceased to exist in that context were it not for the legalized plunder of private endeavors.

Toad734 said...

Soap:

The Postal Service does have competition from UPS and Fed Ex. You can send packages through the US mail and can even send letters through Fed Ex and UPS.

But in that case, its retarded for the Army to advertise during the superbowl because no one is going to go join "Bobs Army".

TRUTH 101 said...

Patrick's views on healthcare interest me. The gist of it seems to be that health insurance should be abolished and everyone pays their own way. I admire patrick's devotion to personal responsibility so much I won't go into risk management or any mundane stuff. Good luck with your teeth buddy. I'll be looking for a crawler on the side of your blog soon asking for donations.

Satyavati devi dasi said...

Well hell.

Between Toad and Tao, I don't believe there's a thing that could be added.

And geez, Patrick, I waited all this time... for this?

Patrick M said...

Toad: You easily fail to differentiate between services that are a reasonable function of the federal government, state and local functions, and slowly creeping giveaways.

Oh, and I'm fully aware of the burden the uninsured in an emergency room add to the expense of health care. And I'm willing to compromise and not have that completely disappear. Although I think, in the case of the junkies, we could solve a lot of our drug problems if we address them when the addict, by his or her choices, becomes a burden on society. More on that next week (if I remember).

As for the bills, if insurance were truly affordable (which it could be), then there would be fewer families bankrupted (and bankruptcy is not the end of the world, merely a protection from creditors.

Now some numbers:


In Canada, they spend 9.7% of their GDP on healthcare for everyone.


And they have to ship high-risk pregnancies to us.

For prescription drugs, Americans spend more than 50% more than what is paid by people in other industrialized nations because costs aren't monitored by any oversight.

This is because we bear the cost of making and marketing the drug, while other countries force the drug companies to sell closer to cost, which only pays for the production.

With private healthcare, Americans have...

You call this clusterfuck private? I think I pointed out that private ended long ago.

With a true nationalized health care system, we would put 810 billion dollars into the hands of consumers and if they were to spend that money it would mean that much more money pumped into the economy and it would actually be taxed generating 56 billion dollars.

First of all, it wouldn't be taxed, because it's already taxed. And you think we wouldn't eventually be taxed more for this universal health care?

Tao: Where do you get the idea that my beliefs are blind? I know, based on everything I've heard and read the direction that will solve the problems we face. I don't know how we get there. But if it's government-supplied/managed/rationed health care you want, then let's just "right" it into existence.

There's a reason we have a Constitution.

101: The gist of it seems to be that health insurance should be abolished and everyone pays their own way.

No, the gist is that when we don't see the bill, the prices start going up. Ask Tao. Or better yet, let m quote him (from an earlier post).

I went to my doctor and asked him how much he charges for an office visit via insurance and how much would he charge me if I paid cash. He did NOT know.

So, we went out and checked his nifty difty computer system. Under my insurance it would cost $86.00 for cash it would be $120.00 and there were nine different rates for a simple office visit depending on which insurance company you had coverage with.


(And either wiping out the insurance for routine shit or universal health care would address this travesty.)

And I specifically didn't get into risk management (AKA CYA medicine), because that's a separate problem, and one that might be partially cured when the doctor has to please his customer a little more (rather than treating and waiting for the insurance company).

Satyavati: What did you expect me to say? Shoot the old people and the gimped up bastards and let the useless die? Then make them into chili?

As for what Toad had to say, I don't argue any numbers (except his savings numbers, which are government guesstimates). But numbers are only a part of this. So the debate is whether a true free market or a government run creature would best resolve these numbers.

TRUTH 101 said...

I've given my health care proposal several times over the last 3 years. I think you're starting to come around. You complain about different rates for different insurance. Are you calling for some regulation here Dude?

Satyavati devi dasi said...

First of all, it wouldn't be taxed, because it's already taxed.

Most employer insurance is done with pre-tax deductions, which means it lowers your taxable income. By a substantial amount at the end of the year (assume $500/month for an average family with mediocre coverage; in reality it can go higher). So there's a revenue loss there for the government in personal income that's non-taxed.

Satyavati: What did you expect me to say? Shoot the old people and the gimped up bastards and let the useless die? Then make them into chili?

Why not? It's what you were really thinking...

You also forgot to address the whole 'negotiated' pricing except very indirectly. All this shit is worked out between insurers and providers; you can look at it kind of like cars; MSRP vs. invoice. The lab test that 'costs' $100 has been negotiated down to $45. If you have insurance. If you don't? It'll be $100.

Medications? That situation is ever so much bullshit. Pharmaceutical companies price their drugs opportunistically (ever wonder why anti-nausea drugs "for cancer patients" are so much more expensive than anti-nausea drugs for everyone else?) and at hugely, grossly, obscenely inflated prices. All that 'we need to recoup our R&D' is ever so much more bullshit. There are recent rulings about what kinds of presents drug reps can bring to offices and hospitals (no more pens, tote bags, clocks, weird sand toys, clipboards, lunchboxes, sticky pads...) but they can still do the bullshit 'conferences' at exotic resorts. And what, exactly, is wrong with forcing drug companies to price their medications a bit more reasonably?
Are you really worried about Pfizer's bottom line? Think they'll go under if we make them be more realistic? Do you have any idea what kind of frickin writeoffs they get and so on? Give me a break.

one that might be partially cured when the doctor has to please his customer a little more

You're treading on the thinnest of ice here, Cletus. This is healthcare, not a hairdresser's. This 'customer service' thing is the icing on the bullshit cake. Not that we shouldn't be polite and professional and not cuss you out when you deserve it; but this mentality gets taken to such an extreme that if the patient doesn't get what the patient wants, regardless of its appropriateness, then it's 'poor customer service'. If you have a blood sugar of 565, I'm telling your husband that no, you can't have that damn Krispy Kreme donut no matter how much you cry over it. I don't particularly care if you like that or not; I refuse to allow something that's under my control to happen if it's to the detriment of my patient. Now, I won't be nasty about it, but it's my job to make sure this shit doesn't go on. I document what I've done and then if you go on and eat it once I walk out of the room and subsequently go into a coma, it's your own fucking fault. 'Appropriate care' and 'patient wishes' don't always coincide. If you want to treat yourself, go the hell home and do it. I saw some of this mentality with my mom when she was sick; I don't know how many times she accused me of being heartless, mean, nasty and a terrible nurse, all because I wasn't doing things that she wanted me to be doing. There's a huge misunderstanding of what 'customer service' means. To me it means doing what's best for my patient. If that means tying your ass down, I get an order and do it. If you're not really happy about that, well, I'm sorry for you. Once it's no longer in the best interest of the patient to do it, we stop. That's patient care.

I told you, and you neglected to mention it in this post, that I believe all for-profit healthcare should be eliminated. The minute profit becomes a motivator, quality of care becomes secondary and begins to suffer. That's the true problem and the real root of all the rest of the problems in the healthcare system; money, not patients, are what is most important.

And if I sound a little bitter about healthcare, you know what kind of week I had.

Satyavati devi dasi said...

Oh, and let me mention that in a study of industrialised nations, the United States ranks last in preventable deaths. Our great-and-glorious system of healthcare, which is so widely praised and adored as the pinnacle of the world's health systems in our finest of all nations by our knowledgeable and truly discriminating citizenry, has the highest rate of needless death in the civilized world.

Oh yeah, we're the best. Just not at what you think.

Gordon said...

See, "preventable deaths" is one of those bullshit terms that can be defined any way you like, especially to include deaths that another reasonable person would throw into a different category.

It's meaningless without context.

Gordon said...

The only way I see to control costs in a "free" system is to deploy an army of nurse-practitioners in front of the doctors. Sniffles and boo-boos can thus be weeded out and treated less expensively.

Either that, or pay doctors a lot less, and import them from third-world medical schools.

BB-Idaho said...

"So, as for the solutions, there is no easy one." Pretty well sums it up, it do.

Satyavati devi dasi said...

'Preventable deaths' are preventable deaths. They include things like nocosomial infections, nocosomial wounds, medication errors, procedural errors, and things like that. They include things that are PREVENTABLE. It's a standard term, not a bullshit catch-all phrase.

I doubt that your 'reasonable person' would class a death secondary to a subdural hematoma acquired when the patient fell in his room as something other than a 'preventable death'.... which it is.

It is its own context.

Beth said...

Don't worry Patrick, Geitner is getting powers galore with no apparent oversight so he'll just start telling doctors how much they are allowed to get paid for their work.

What about the ridiculous cost of malpractice insurance? Can we do something about frivilous lawsuits please?

TAO said...

Yep, Patrick, BLIND and that goes for Soapy too!

Lets look at healthcare.

Our options are quickly becoming:

1. Continue on our current path and reach a point where a majority of Americans have no health insurance.

Thats basically it.

You know things are bad when insurers are agreeing to not charge extra for really sick people and doctors and hospitals are all getting on the getting on the same bandwagon of doing whatever they have to do to get paid.

Its obvious that no one believes that the free market offers any solutions...SO....

We can either allow our healthcare system to go the way of our finanicial system should have gone or we can go the way that our financial system went....

What you need to REALLY be asking is if this country is so great why is it that our financial system crashed and had to be bailed out and our healthcare system is dying for a bailout and wants government involvement so to find a solution.

Or we can continue to rant about government incompetence....

It looks to me like everyone one in this country is running to the government for a solution....oh, and welfare queens don't travel in corporate jets!

Looks to me, and to those who actually READ Karl Marx that capitalism does evolve into socialism....he just figured it was due to the demands of the people...not the elites.

Satyavati devi dasi said...
This comment has been removed by the author.
TRUTH 101 said...

I appreciate the freedom of healthcare I get through my HMO. They tell where to go. Decide what tools are used to diagnose. He don't need an xray or MRI. Just look at him. And if I get a settlement from another party for pain and suffering my HMO can sue me for the proceeds. But I appreciate the freedom of our currnet system.


I hope you can all figure out I am being sarcastic. There is no freedom in our healthcare system. You're at the mercy of the provider. I guess Patrick would say he's free to die if he chooses not to bankrupt his family if he gets seriously ill without health insurance on himself.
I dn't want any harm to come to you Patrick. That's why I support single payer national health insurance. I hope you live a long healthy life Brother.

TAO said...

In the late 80's I went to the emergency room one night because I somehow put my fist through a wall...

I paid cash and told them so...

I got a bill for a doctor, use of the room, stitches, and supplies and equipment that totalled $800 for 5 stitches (no xrays..it was the middle of the night) The supplies and equipment was some thread, a needle and some cleaner and ointment. The equipment was something like a pair of pliers to pull crap out of the wound...

that was $200 and I told them that at that rate I believe I BOUGHT the supplies and the equipment and I wanted to take it home with me...

They wouldn't let me have it...

I told them that they could get pliers at ACE hardware for $1.39 and cut their costs...

They thought I was strange....

Beth said...

Here's my personal beef with Universal Health Care. Let's first talk about the bank bailouts, shall we? Once the government started paying to save banks, or AIG, then Americans starting thinking that it is okay for the government to tell them how to run their business, how much they can pay for things, right? Now the government starts having me pay for YOUR healthcare. Can I start telling you how to live your life to be healthy? Can I force people to eat 5 fruits and vegetables a day, get 30 min. of exercise to be as healthy as they can be? Can I tell women they must breastfeed their babies, since that is the healthiest option? If I was paying for my neighbors health care, I would want to start watching how many cookies they eat, how much they smoke, you get the picture...

Shaw Kenawe said...

Can I start telling you how to live your life to be healthy? Can I force people to eat 5 fruits and vegetables a day, get 30 min. of exercise to be as healthy as they can be? Can I tell women they must breastfeed their babies, since that is the healthiest option? If I was paying for my neighbors health care, I would want to start watching how many cookies they eat, how much they smoke, you get the picture...

Beth, we're already providing government healthcare to senior citizens. And, to the best of my knowledge, no government agency goes into the homes of people over 65 to tell them to eat their fruits and veggies and to exercise.

Even though that would benefit them and probably allow more than a few of them to live healthier lives.

Satyavati devi dasi said...

Shaw,

I think Beth feels like since 'she' is going to be paying for 'other people's' healthcare, 'she' wants the right to micromanage their lives to ensure that 'her' healthcare dollar is spent wisely.

People love to focus on this idea that 'they' will be paying for 'other people's' healthcare. Beth may not realize that under a single-payer system, 'she' is not paying for 'other people's' healthcare, she's paying into her own, and everyone else likewise.

This is up there with the way people freaked about the tax cuts; that they were going to be 'redistributing my hard earned wealth to some crack whore who gets welfare already'... when in reality, they themselves would be benefiting from the tax cuts. (I don't know about you, but I've seen it in my checks.) I'm not sure what provokes this mentality but it seems like it happens all the time.

And yeah, Beth, maybe if everyone felt like emphasizing preventative care, health-care, good nutrition and so on, that would help. It would also help if those things were universally accessible. Do you realize that the vast majority of lower-income people don't eat properly because it costs more money to eat fresh fruits and vegetables than it does to buy preprocessed, dehydrated, chemical-laden foods? Exercise is great-would you like to go out for a jog in the barrio with me? Dodging bullets is a super cardio workout.

Cmon, let's go.

Beth said...

I just think it's pretty hypocritical to say that since the government "owns" companies like AIG and now apparently GM, they can start telling them how to run their businesses, but God forbid we tell people whose healthcare we might pay for what they can and cannot do.

I'm all for people paying out of pocket to really see what things cost, and have insurance for the big things only (like home insurance, you don't use your home owners insurance to pay for paint or maintenance of your home, but for unexpected, beyond your control things like a fire you use insurance, right?)

Beth said...

Is jogging outside the only exercise in the world?

Satyavati devi dasi said...

Preventative healthcare can reduce long-term health costs by billions of dollars every year.

By making preventative healthcare accessible and available, you can effectively lower total healthcare cost.

Example: many heart attacks can be prevented by taking a baby aspirin every day.

The baby aspirin, at a cost of less than 0.05/dose, can prevent the heart attack at a cost of 40-80K.

You change the oil in your car every 3k miles so that your engine doesn't seize and cost you a replacement.

Again.. by providing the prevention, we can reduce a substantial amount of the 'big stuff'.

And if you'd like to do Richard Simmons in your apartment instead of going outside, I hope that your downstairs neighbour, who sleeps during the day because he works at night, sleeps hard. And I hope you have the room to bounce around in.

Beth said...

Exactly my point, if tax dollars are used for everyone's healthcare, then I demand everyone maximize the preventative stuff so as to minimize the healthcare costs. Why is that wrong?

Patrick M said...

101: I honestly don't know. But I'm more and more certain that the cash customers pay more because the insurance companies and the government pay less.

Satyavati: And what, exactly, is wrong with forcing drug companies to price their medications a bit more reasonably? [emphasis added]

The emphasis says it all. What's the motivation to make new drugs when the government is going to tell you what you can make? And that covers the rest of your rantings about the pharmaceuticals.

You also forgot to address the whole 'negotiated' pricing except very indirectly.

While the insurance companies may negotiate those prices down (in exchange for exclusivity with certain doctors), I'm pretty certain the government doesn't.



This 'customer service' thing is the icing on the bullshit cake.

The same principles apply, even if it's not necessarily a 'customer is always right" atmosphere (as the customers are usually idiots at that particular time). And what you describe is good customer service: Doing right by the customer. Back when I did sales, I occasionally dissuaded people from buying things they shouldn't.

I told you, and you neglected to mention it in this post, that I believe all for-profit healthcare should be eliminated.

That's probably because it was my post. And because we'll make health care work again only by making it worthwhile for the best (who command the most money) to get into it.

Our great-and-glorious system of healthcare, which is so widely praised and adored as the pinnacle of the world's health systems in our finest of all nations by our knowledgeable and truly discriminating citizenry, has the highest rate of needless death in the civilized world.

Actually, I thought it was a clusterfuck that needed fixed. And what Gordon said right after.

BB: If it were that easy to solve....

Don't worry Patrick, Geitner is getting powers galore with no apparent oversight so he'll just start telling doctors how much they are allowed to get paid for their work.

And then doctors will be government employees.

Tao: Its obvious that no one believes that the free market offers any solutions...SO....

Uh, I do.

We can either allow our healthcare system to go the way of our finanicial system should have gone or we can go the way that our financial system went....

Already done. That's why we're in such a mess in both sectors.

As for the rest, I'll let you ladies have at each other. Reminds me of a video I downloaded....

Toad734 said...

Patrick:

You fail to see that the government keeping its citizens alive, healthy and happy is a reasonable function. In fact, a few years ago a Republican congress held an emergency session to try to save one persons "life". So apparently I am not the only one who thinks we should keep people alive.

And so why should the US bear the cost of the drug companies R&D?? Why not make China do it? Why does my Zyrtec have to cost so much? And you are fooling yourself if you think they need all that money for R&D, they need it to line their pockets, hire lobbyists and pay off congress. And you are the sucker who is defending that practice.

And in state funded health care, junkies could go in for treatment before they go out and overdraw bank accounts, flip their cars, rob old ladies, overdose and rack up $20k in hospital bills, get picked up by the police, spend time in jail, tie up the courts,etc.

Trust me, a preventative system would be cheaper than the one we have now on so many different levels. My brother is a junkie; my parents can't afford to send him to a place like Betty Ford so he has repeated the above patter over and over again for the last 15 years. Tax payers/society paying $1000 a week to go to rehab would have been a lot cheaper than not treating him. But for the rest of us, there isn't as much profit in a preventative system like we would have if we had universal health care such as in the UK.

I think if you got shot downtown of a major city, after seeing a US hospital and then seeing a Canadian hospital, you would choose the Canadian one especially with its price tag. All the scare tactics shit in the 90s about Canada and waiting to see a doctor was all bullshit. Guess what, when I make an appointment with a doctor here I won’t actually end up seeing them for another week.

What I am talking about with the 800 Billion being taxed is that if consumers were spending $800 billion at Circuit City instead of pain medication, Circuit City would still be in business. Right now, a portion of medical bills are even tax deductible so that would be a lot of revenue in the economy and a lot of revenue that would be taxed when consumers spent it on something else which could help pay for a national health care system.

Our health care system is broken, plain and simple and you are being lied to.

TRUTH 101 said...

Beth would rather a faceless bureacrat in India decide what treatment she's entitled to rather than our own government providing a single payer plan that we all support. Good luck Beth. I don't want you to die either.

Toad734 said...

Oh, and I just saw a thing talking about how name brand prescription drugs are marked up 350%. So ya, not R&D.

Patrick M said...

Toad: You fail to see that the government keeping its citizens alive, healthy and happy is a reasonable function.

Yes, no, and no.

In fact, a few years ago a Republican congress held an emergency session to try to save one persons "life". So apparently I am not the only one who thinks we should keep people alive.

Haven't I pointed out enough that Congress wastes its time doing things they don't need doing?

And so why should the US bear the cost of the drug companies R&D??

We shouldn't. But as other companies control the price, we're it.

...they need [money] to line their pockets, hire lobbyists and pay off congress.

No problem with them making money. As for the practice of lobbying, that's their right as well. But the blame goes to those they've bought, and a system that encourages legislating everything.

As for your brother, you'll find me in agreement. But that dovetails with decriminalizing drugs and treating it as a social problem rather than a criminal one. That's for another post.

Our health care system is broken, plain and simple and you are being lied to.

Yes, to the first part. As for the second part, who''s lying to me? I'll assume it's you because you're the one pushing the point of view.

Beth said...

Okay Toad if preventative care costs less, then why don't more people do that? It's because right now they either figure their health insurance will pay for any bad health, or they have no insurance and oh yeah, hospitals cannot turn away anyone if they cannot pay so where is the incentive to be preventative?? If everyone actually had to pay for doctor visits themselves, maybe they would think twice about smoking, or being a couch potato. So how come I cannot (if I am paying for everyone's insurance make their getting it contingient upon them doing preventative things?

TRUTH 101 said...

You ever heard of copayments and deductibles Beth?

I may have to put my plan back up but I don't want Patrick to accuse me of copying him even if it would enlighten he and Beth.

Gordon said...

Satyavati devi dasi wrote:

"many heart attacks can be prevented by taking a baby aspirin every day.The baby aspirin, at a cost of less than 0.05/dose, can prevent the heart attack at a cost of 40-80K."

Great! As it happens, I do this myself.

How much will it cost to have the government bring everyone in and start handing out baby aspirin?

"You change the oil in your car every 3k miles so that your engine doesn't seize and cost you a replacement."

Exactly. I do this, because if the car breaks, I know the government isn't going to buy me a new one. But many people ignore sound maintenence. Shall we nationalize auto repair?

Then again, Obama may have done that today.

Beth said...

I can't help but notice that my concern that if Obama can start telling GM who to fire, then having him run things such as our healthcare could result in similar results in our own lives...

Satyavati devi dasi said...

I'm pretty certain the government doesn't.

They most certainly do. Medicare has a set price they're going to give you and you're going to take it. Hence the whole 'costing out' that private places do. I wouldn't call it negotiating, because there isn't any. They tell you what they're going to pay.

Preventative medicine: This is what I keep saying. If we can make preventative care ACCESSIBLE to EVERYONE, we can lower the cost down the road. And Beth, if you don't think you're paying for other people's healthcare now, you are, in the form of your premiums. You see, it's like a big lottery. You pay your $100 premium and so does everyone else. If you don't get sick, the $100 you paid in your premium goes to pay someone else's bill. If you do get sick, then it might go to pay yours.

We have made big strides in recent years by finally getting insurance companies to pay for things like mammograms and pap smears, which, don't you know, are preventative. Now many more diagnostics such as colonoscopies and so forth are covered because the companies have realized that spotting and removing a polyp is cheaper than finding stage 4 cancer and its subsequent treatment. It's good mathematics and good sense; stitch in time saves nine. Significant savings have been seen by early detection and prevention.

As far as drugs go: today I was in dire need of some allergy medicine. Claritin, which is now over the counter, was 14.99. Loratidine, its generic equivalent, was 4.49. Side by side on the shelf. I imagine it must be all that fancy ink on the box that jacks the price up. You can just guess at which one I bought. I'm not so good with math, but is that a 300% markup?

oh yeah, hospitals cannot turn away anyone if they cannot pay so where is the incentive to be preventative??

Only PUBLIC hospitals can't turn you away, and this is only in emergency situation. Private facilities can, and do, turn you away if you don't have a payer source.

I can tell you what absolutely will PREVENT preventative care: the inability to access and or pay for it. Would you go to a doctor when you weren't sick, if you had to decide between that and your mortgage? That's the issue. Getting preventative care covered is a huge first step. Also, like I mentioned earlier, a lot of basic things like good nutrition are highly difficult for lower-income families as the cost of fresh produce, etc., is considerably higher than preprocessed foods. If it comes down to being able to spend your only $20 and get 5 meals vs 2 meals and you have a bunch of kids to at least fill stomachs, which do you choose?

There is also a huge education gap here, which is a seperate yet intertwined problem and one that requires a lot of work on the part of people like me. You have no idea how difficult it is to teach people who can't read the right way to take their medicines (if they will even have money to get them once they get home) and to do other self-care.

Patrick M said...

101: Come on, man up. Put that health plan up there so we can savage you for it. :)

Saty: They most certainly do. Medicare has a set price they're going to give you and you're going to take it. [emphasis added]

Get the quote right: While the insurance companies may negotiate those prices down (in exchange for exclusivity with certain doctors), I'm pretty certain the government doesn't.

This is why I have a problem with government getting involved further. They will decide what the "right" price is. That's price fixing, and it kills the motivation if self-interest hella-quick. And we are all motivated by our self-interest. Take that away and we fail as people.

Beth said...

Indeed, the government does not have the motivation of profit, so what does it do? It either works inefficiently or it legislates prices and sets the market value. Well don't be surprised if smart people stop going to med school and scientists stop trying to develop life saving drugs because they don't like their careers being limited by government.

Satyavati devi dasi said...

The minute that we take the mission out of medicine and make it purely a for-profit business, the patient suffers.

Patients come FIRST.

FIRST.

By allowing hospitals and companies to put profits first, CARE SUFFERS.

Don't you think I see this every day? Where supplies are cut, staff is cut, you don't have the who or the what to do what you need to do for your patient? Don't you think I've seen with my own eyeballs that bad things have happened to patients who needed 1:1 care and extra staff weren't allowed by administration because it's more money? Don't you think I've seen this shit?

What, do you think I make it up for dramatic effect?

The second you put making money higher on your priority list than taking good care of people, care SUFFERS.

CARE is no longer your motivator.

MONEY is your motivator.

You don't give a shit about the people, as long as you get paid.

THIS is the problem, bud to root.

Trust me on this.

Patrick M said...

Saty: The minute that we take the mission out of medicine and make it purely a for-profit business, the patient suffers.

I don't think anybody has suggested that. I know I woulnd not want that.

But likewise, the minute we take all the profit motive out of medicine and make it purely a mission, the patient also suffers.

Okay, maybe not the exact minute. But as the profession of doctor, which takes years of investment of time and money to achieve, as well as medical research, which is simply subsidized rather than driven by the potential profits of a breakthrough, what will drive the best and brightest to push that much harder.

There will still be people that give a shit, that believe (you're one of them). But (and the Obama administration has show the way with GM) as the government starts replacing corporate leaders with bureaucrats, how many people will check out of giving a rats ass and just punch the clock?

There's a balance in a good free market system that values balance and ethics as key components in making good profits. This has been something that has been neglected in many ways (we all know the list), but is returning.

Again it comes back to trusting either the individual who is motivated by self-interest or a large, faceless government motivated by political interest. And I trust the self-interest of the individual.

Beth said...

Exactly Patrick, no "system" of health care, or any business or government is perfect because botton line is that people are imperfect. Having individual choices for doctors and nurses to do what they want to do, as well as patients having choices for their care is the best, is it not? Throw a third party in there calling the shots and all of our choices get limited. But at least when that third party has some motivation to keep both sides satisfied, then there is (in my opinion) a chance for compromise. The government being in charge doesn't give any choices to anyone, so where is the motivation?

Satyavati devi dasi said...

Having individual choices for doctors and nurses to do what they want to do,

What exactly is this supposed to mean?

I and any healthcare person can work in any one of a million specialities regardless of who's on top writing the checks.

Satyavati devi dasi said...

And whether you know it or not, the best jobs right now out there are government-run; whether state, county, or federal.

Federal is actually the best of them.

Those jobs beat the shit out of any private company or public hospital you might be able to work for.

Beth said...

From the perspective of the government employee, sure its the best job around, no need to worry abouy pay cuts or job loss like the rest of us, but that doesn't mean all those jobs we taxpayers support are actually necessary or efficient. And everyone cannot work for the government, can we?

As for who is writing the checks, I again mention AIG and GM as a point of reference for how our federal government thinks that because it is "writing the checks" that they can call all the shots, so what makes you think you specifically will get to do the job you desire, and not the one they decide for you that you are more needed in?

Satyavati devi dasi said...

what makes you think you specifically will get to do the job you desire, and not the one they decide for you that you are more needed in?

That happens now. Every job I've ever worked has the power to put me wherever I'm needed most as long as I'm qualified to do it. They have the power to change my schedule to whatever will suit them best. They have complete control to take me from the place I've been put and into some other place where they think they need me more. On a daily basis, in fact.

What, you didn't know this happens?

Beth said...

I presume you work at the facility of your choice and in the state in which you live? Sure, any of us at our job can be asked to do whatever needs to get done at times.

So Saty, have you figured out yet how we can ALL get federal government jobs, huh?

Satyavati devi dasi said...

Sure.. go to school for something vitally important and currently in shortage nationwide.

Be good at what you do.

You'll get hired.

Beth said...

Not surprising you missed the point.

Toad734 said...

Im pushing a point of view and that means I am lying? What do you call this blog? Check my facts if you like but don’t say I am lying without knowing that I am lying.

Yes, my point of view is that health care costs are ridiculous and its Nixon's fault with his HMO bullshit. Yes my point of view is that I want the health care system to treat me as a patient that they try to keep healthy and productive not as a customer who bleeds money.

This free market bullshit only goes so far. If one Burger King holds a special saying that they will give away a free drink to anyone who buys a whopper, I am sure their corporate heads would allow them to do that as they are independently owned franchises but if one franchise decided to fry their burgers instead of flame broil, corporate would ultimately have to come down and put the kibosh on them. So free market principles, even in health care may have some place but not when it comes at the expense of your kid’s health or choosing which detached finger you can afford to have sewn back on.

Patrick M said...

Toad: Im pushing a point of view and that means I am lying?

Actually, you're the one who brought up the lying. I'm just being an ass. :)

My point on that was that I'm not getting talking points from any one person and believing them without prejudice. The problem was that you were assuming I was buying propaganda without looking who was selling. Thus, the assitude.

This free market bullshit only goes so far.

Therein lies the problem, and the point we're never going to agree on. I'm always going to choose the free market, in which everyone is motivated by self-interest, but with no one having police power over another, before considering government, where everyone is motivated by self-interest and one of those groups has legal police power to compel compliance.

As for your Burger King example, you neglect to mention the principle that allows corporate to enforce things like flame broiling: a Contract. The franchise does not have to remain a Burger King, but to be able to do so (as corporate owns the name), they have to agree to do certain things.

How this relates to sewing your kid's fingers back on is a little beyond me. As for me, I know I'd come up with a solution (with or without cash in hand).

Beth said...

How this relates to sewing your kid's fingers back on is a little beyond me. As for me, I know I'd come up with a solution (with or without cash in hand).

Therein lies the big difference between liberals and conservatives. Libs prefer to look to someone else to come up with solutions, conservatives look to themselves. We think most people are capable of doing the same (even the libs).

Satyavati devi dasi said...

Beth will you PLEASE.. PLEASE.. stop grouping people?

I despise this generalized "LIBS"
pigeonholing.

Just like you don't consider yourself a republican, I am sure there are other 'conservatives' out there you'd not want to be grouped with.

I happen to be a Socialist of the SPUSA variety and I am sick of being stereotyped and heaped into one class for your abusive convenience.

Thanks and have a nice day.

Beth said...

For one thing, my comment was from something Patrick said in his response to Toad, my comment was not directed at anything you said Saty.

However, that being said, there is a difference between a party and an ideology. I don't consider myself a Republican because they abondoned the conservative ideology. Liberalism on the other hand is the polar opposite of conservatism, so whether the liberal is a Socialist or a Democrat, doesn't matter, it all is a stupid ideology.

Satyavati devi dasi said...

Liberalism on the other hand is the polar opposite of conservatism, so whether the liberal is a Socialist or a Democrat, doesn't matter, it all is a stupid ideology.

You don't even know the difference between them, but they're all stupid?

This is the same mentality that says, "No, I don't PERSONALLY know any (insert minority) here, but they're all crackheads, pimps, gangsters, illegal, on welfare, etc."

This is a mentality that makes judgements without knowing wtf they're talking about.

I'm done with you.

Beth said...
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Satyavati devi dasi said...
This comment has been removed by the author.
dmarks said...

Toad said: "You mean like the postal service who can send a letter 3000 miles in 3 days for $.42?"

Soapbox is correct. They can't. You have to spend about $4.95 for "priority mail" to do this, and even then they don't guarantee it. For that, you have to pay even more for insurance/conformation/etc.

Health care is way too important to take away from the people and put in the hands of the ruling elite. The government is an unaccountable monopoly.

Beth said...

I will apologize for making personal assumptions, but I will not apologize for being blunt. I am tired of pussy-footing around my feelings, and so I called liberalism stupid because that is what it is. Let's say you are a person who struggled, but made it, and so you think of liberal ideas as giving other people help to do the same. But if you yourself got through your struggles without the government handing things to you, then why can you not see that anyone else can do the same? And if they truly cannot help themselves, then there are people in the private sector and in charities that can help? There isn't anything the government can do that cannot be done by individuals, and I think individuals can do it better.

Toad734 said...

Beth:

There are so many things you are wrong about.

Ill start with your question to me of why aren't people doing preventative if its cheaper than the alternative. Well, first of all, your mammograms are covered by your insurance because they know that they will pay thousands in cancer treatments and then you will die thus no longer be able to pay premiums and then will have to pay your family life insurance if they don't cover the cost of your mammograms. However, that is rather rare, most insurance companies wont even cover the cost of birth control even though them paying for the delivery of a baby is much more expensive. But, then again, your baby will also need insurance so they will make money on that as well. And why let an insurance company decide who can and can't have babies?

And with the case of someone like my brother, they just wont give them insurance at all because the cost of prevention is high but the cost of his emergency room visits are higher. Plus, they don't have to pay his court costs, they don't have to pay the police to keep tabs on him, they don't have to pay his bad debt he racks up, they don't have their shit end up in a pawn shop, they aren't being robbed by him on the street, they aren't having to pay for the car he flipped, they don't have to pay for his food while in jail, etc.

So, while prevenative may not always be cheaper for an insurance company, it will always be cheaper for society at large.

As for you other statement about Conservative coming up with their own solutions I call bullshit. Who are the ones who are having to fix the mess your conservative hero Bush got us into?

What solutions have Rush Limbaugh given for our economic melt down? Nothing, but blame democrats and black people who were given loans.

What solution has Oreally, inSannity and Colmes, Limp Beck, Stan Coulter and all the others come up with on Iraq, the economy, carbon emissions, etc.? Nothing, only to deny the problems and point blame. Or just say, "too much government". But that isn't a solution. And in reality, its the liberals who face the music and realize something has to be done, conservatives just think if you pray, then deregulate everything (except sex, marriage, drinking ages, drug laws, porn, etc) then everything will just work out. Again, they have done that before and you get S&L, Ponzi Schemes, the Mortgage Crisis, Enron, etc.

Just because your ilk sells that message doesn't mean they live by it.

Its the Roosevelts, Kennedys, Clintons and Obamas who always have to clean up the mess made by the Republicans.

Satyavati devi dasi said...

Insurance companies are indeed now covering things like birth control and preventative diagnostics such as mammograms, paps, colonoscopies and so on, especially if you fall into a high-risk category.

Some higher-tier insurance policies are actually covering ALL diagnostics at 100%.

But this was not due to some gentle-hearted soul at an insurance company thinking wouldn't it be great to save people so much suffering. It wasn't even due to insurance company finance specialists pointing out than an $1800 colonoscopy is far cheaper than a $235K course of cancer treatment.

It was due to the government mandating that these things need to be available and accessible and thus covered.

Prevention IS cheaper than cure in small numbers, but the insurance companies were basically gambling in big numbers:
one $235K cancer treatment is still cheaper than 10,000 $1800 colonoscopies.

Of course, the insurance companies aren't paying $1800 (or $235K for that matter) but the point remains.

Toad734 said...

Dmarks:

Health Care is in the hand of the ruling elite right now. Or was that supposed to be a joke? The CEOs of Humana, Blue Cross, etc. all make far more money than the President and probably have more political power and influence than the president. These are the guys who wrote the laws which created HMOs.

They are the ruling elite. So I assume you are for taking it back from them?