Freedom or Socialism?

[Clare73]

That statement is in conflict with wit this statement:

You must be misunderstanding me, for they say the same thing:
the reason insurance is such a mess is because the government required insurance to operate as insurance was designed not to operate; not as a sraight-forward reimbursement plan, but as financial provision for unknown future risk (not for future certainty as in pre-existing conditions).
That model makes it cost prohibitive, forcing reduction of beneifts to be affordable.

 

[RDKirk]

You must be misunderstanding me, for they say the same thing:
the reason insurance is such a mess is because the government required insurance to operate as insurance was designed not to operate; not as a sraight-forward reimbursement plan, but as financial provision for unknown future risk (not for future certainty as in pre-existing conditions).
That model makes it cost prohibitive, forcing reduction of beneifts to be affordable.

"Insurance" is fundamentally a poor model for health coverage because the risk of payout is a virtual certainty. It's like providing flooding coverage for New Orleans. Heath care should be covered by various cost-sharing methods, not insurance.

 

[MorkandMindy]

For-profit healthcare means healthcare and profit both have to be funded

so either the healthcare will cost twice as much, or the quality will be half as good, or some balance between these which is the present situation in the US

 

[pacomascarot]

For-profit healthcare means healthcare and profit both have to be funded

This is incorrect. Healthcare needs never really be funded. Profits, however MUST.

 

[FireDragon76]

I'd like to see us get back to the point where we can simply pay out of pocket for most basic procedures without the need for medical insurance.

That's not practical considering some illnesses can be catastrophic to pay for, for the individual, and sometimes it's the roll of the dice if you'll get one of those illnesses. That's why we have health insurance in the first place, it's a form of pooling of risk.

 

[98cwitr]

That's not practical considering some illnesses can be catastrophic to pay for, for the individual, and sometimes it's the roll of the dice if you'll get one of those illnesses. That's why we have health insurance in the first place, it's a form of pooling of risk.

Then ask yourself, "Why do they cost so much?" Whether it's the government paying or the individual, the price is what should concern all of us. There should be nothing that is "catastrophic" and people should be able to pay what they can. Hippocratic Oath demands it actually.

I got a $1200 MRI bill back in February, and that was after insurance paid the bulk of the total bill, which was over $6000. I've been paying $100/mo on it since then and almost have it paid off. No line of credit, no questions asked. Now, if my state's certificate of need law was repealed, it would have only been $500. The government, in my state, is driving up the cost...not lowering it.

My wife recently had an ER visit. She was there 6 hours, from walking in the door to discharge. Total charge: >$14k. That's insane. Absolutely insane.

 

[RDKirk]

Then ask yourself, "Why do they cost so much?" Whether it's the government paying or the individual, the price is what should concern all of us. There should be nothing that is "catastrophic" and people should be able to pay what they can. Hippocratic Oath demands it actually.

I got a $1200 MRI bill back in February, and that was after insurance paid the bulk of the total bill, which was over $6000. I've been paying $100/mo on it since then and almost have it paid off. No line of credit, no questions asked. Now, if my state's certificate of need law was repealed, it would have only been $500. The government, in my state, is driving up the cost...not lowering it.

My wife recently had an ER visit. She was there 6 hours, from walking in the door to discharge. Total charge: >$14k. That's insane. Absolutely insane.

My daughter went to an ER for what she thought could be serious eye injury. They did absolutely nothing more than the optometrist at Walmart would do. They looked in her eyeball and gave her some drops. Charged $11,000.00. My wife--who is an extremely talented negotiator--got them down to $4,000. But that was still a crime.

(My doctor recommends not going to one of these Texas strip mall ERs unless you're absolutely bleeding out. He says always go to an ER that's connected to a hospital. That way, if you have to go to the hospital for anything--MRI, operating room, whatever--you won't have to spend any more time being admitted and the ER doctors will already have privileges at that hospital to get you priority.)

Hospitals and doctors don't set their prices according to the cost of goods and services policies of other businesses. They charge as much as they want to charge--like universities. I've mentioned before that I've recently had a procedure done by a local urologist. He specializes in this procedure. It's practically all he does. But it's an "old man's procedure" almost universally done for men on Medicare.

Medicare paid him only 10% of what he charged me, and I don't think that changes from one old man to the next old man. If his charges represented a reasonable cost-based price (like other businesses), and he's regularly getting only 10% of what he charges, he'd be out of business. This is a game they're playing.

 

[98cwitr]

My daughter went to an ER for what she thought could be serious eye injury. They did absolutely nothing more than the optometrist at Walmart would do. They looked in her eyeball and gave her some drops. Charged $11,000.00. My wife--who is an extremely talented negotiator--got them down to $4,000. But that was still a crime.

(My doctor recommends not going to one of these Texas strip mall ERs unless you're absolutely bleeding out. He says always go to an ER that's connected to a hospital. That way, if you have to go to the hospital for anything--MRI, operating room, whatever--you won't have to spend any more time being admitted and the ER doctors will already have privileges at that hospital to get you priority.)

Hospitals and doctors don't set their prices according to the cost of goods and services policies of other businesses. They charge as much as they want to charge--like universities. I've mentioned before that I've recently had a procedure done by a local urologist. He specializes in this procedure. It's practically all he does. But it's an "old man's procedure" almost universally done for men on Medicare.

Medicare paid him only 10% of what he charged me, and I don't think that changes from one old man to the next old man. If his charges represented a reasonable cost-based price (like other businesses), and he's regularly getting only 10% of what he charges, he'd be out of business. This is a game they're playing.

I sincerely appreciate the reply, but we're still dancing around the issue: Why is he charging so much for services?

 

[pacomascarot]

I sincerely appreciate the reply, but we're still dancing around the issue: Why is he charging so much for services?

Often times hospitals charge a lot for small things to offset the cost of ER care which is offered regardless of insurance status. For whatever reason Americans simply won't allow a person to crawl into an ER and just die. Instead the ER is bound by law to provide stabilization of the injured person even if they can't pay.

The hospitals pass along the cost to those of us who CAN pay.

It's grossly unfair because it means there are people who are SURVIVING EVEN WHEN THEY DON'T EARN THE RIGHT!

Alas, such is our system.

Oh yeah, and sweeeeeeeet profits! Some charges go up for that reason too!

 

[rjs330]

Oh I think we can dispense with that line of reasoning. You see I am a professional researcher. So I've done a lot of my own research. I'm willing to bet dollars to donuts I've done more than you have! And I got paid to do so.

I just don't look up every single goofy thing someone rattles off.



It says it is.



Methinks you don't know anything about insurance yet. Wait til you get your first real job. Then tell us all about it.

A professional researcher. So some else pays you to do research. Somebody is making money in order to pay a professional researcher.

 

[pacomascarot]

A professional researcher. So some else pays you to do research. Somebody is making money in order to pay a professional researcher.

yup. Ever hear of R&D? What do you think the R stands for?

 

[rjs330]

How much planning, management and nursing of the job do the people who currently work for Jeff but who require public assistance to stay alive do?

Jeff's parents took the initial risk they deserve the majority of the gains. Remember we are debating why people who found companies can get paid millions of dollars per hour while others who keep the company running earn much, much less (to the point where tax payers need to help pay for their food).

Who is forcing them to work for Jeff?

We all know Jeff has spent his life with his feet in his desk and didn't do squat. And the money just poured in. And those box packers, well that a rare skill indeed. It take no more skill, brains, and talent to pack a box than it does to start, create and run a huge company. Yeah, no difference at all.

By the way, Jeff goes around and makes people work for him at gunpoint.

 

[pacomascarot]

Who is forcing them to work for Jeff?

We all know Jeff has spent his life with his feet in his desk and didn't do squat. And the money just poured in. And those box packers, well that a rare skill indeed. It take no more skill, brains, and talent to pack a box than it does to start, create and run a huge company. Yeah, no difference at all.

By the way, Jeff goes around and makes people work for him at gunpoint.

Get back to us after you’ve been in the workforce a bit

 

[HARK!]

MOD HAT ON

MOD HAT OFF​

 

[RDKirk]

Often times hospitals charge a lot for small things to offset the cost of ER care which is offered regardless of insurance status. For whatever reason Americans simply won't allow a person to crawl into an ER and just die. Instead the ER is bound by law to provide stabilization of the injured person even if they can't pay.

The hospitals pass along the cost to those of us who CAN pay.

It's grossly unfair because it means there are people who are SURVIVING EVEN WHEN THEY DON'T EARN THE RIGHT!

Alas, such is our system.

Oh yeah, and sweeeeeeeet profits! Some charges go up for that reason too!

I'd believe that if hospital bills listed reasonable line item charges for everything else with a "deadbeat surcharge" at the bottom.

 

[98cwitr]

Often times hospitals charge a lot for small things to offset the cost of ER care which is offered regardless of insurance status. For whatever reason Americans simply won't allow a person to crawl into an ER and just die. Instead the ER is bound by law to provide stabilization of the injured person even if they can't pay.

The hospitals pass along the cost to those of us who CAN pay.

It's grossly unfair because it means there are people who are SURVIVING EVEN WHEN THEY DON'T EARN THE RIGHT!

Alas, such is our system.

Oh yeah, and sweeeeeeeet profits! Some charges go up for that reason too!

Those who "can't pay" have medicare and medicaid though, right? I don't understand the validity of such an argument or statement. I doubt either of us will submit any defense to our current system, but our solutions are quite different.

I was told by my provider and insurance company that I have no self-advocacy when it comes to pricing. Prices are determined between the insurance company and healthcare provider and there's simply nothing I can do about it. I'd rather see people's choices back in their own hands, and their own medical powers restored to them.

 

[RDKirk]

Those who "can't pay" have medicare and medicaid though, right?

No. It's easy for a person who doesn't qualify for Medicaid because of income to fall into the "can't pay" category when it comes to catastrophic illnesses. That's why there are so many medical bankruptcies.

 

[98cwitr]

so many medical bankruptcies.

I believe such a claim to be conjecture. As I said previously, I paid down a >$1000 bill for a MRI $100 a month. No bankruptcy filed. I could have done $50/mo; or whatever.

 

[RDKirk]

I believe such a claim to be conjecture. As I said previously, I paid down a >$1000 bill for a MRI $100 a month. No bankruptcy filed. I could have done $50/mo; or whatever.

A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the research found.

This is the real reason most Americans file for bankruptcy (cnbc.com)

 

[98cwitr]

This is the real reason most Americans file for bankruptcy (cnbc.com)

More recent numbers show it's actually around 46%: Bankruptcy Statistics up to 2021 - What You Need to Know

Missing work aside, we both agree the costs are too high. I propose that repealing certificate of need laws would be a solid first step into driving down costs. Costs between state run hospitals and private ones are comparable, so why is the state charging so much for medical procedures, then denying competition via regulatory laws, and then trying to be the solution to the problem they themselves have created?