Author Topic: Universal Health Care  (Read 38628 times)

Don't care

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Re: Universal Health Care
« Reply #75 on: November 19, 2008, 03:07:39 PM »
Yep.  Black market medicine coming soon.  Hooray.

Do you even know what a capitation is?

It drains the payer system (including public payer systems) of needed monies, all in the name of a patient to have a doctor that will see them.

AZRedhawk44

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Re: Universal Health Care
« Reply #76 on: November 19, 2008, 03:15:17 PM »
Do you even know what a capitation is?

It drains the payer system (including public payer systems) of needed monies, all in the name of a patient to have a doctor that will see them.

Yes, I used to be a DBA for a medical billing and records company.  I saw the contracts spiralling higher and higher in cost each year for each common procedure code, and I saw in my clients' databases the number of uninsured that were simply "written off."

But, the practice didn't "write off" the pay of their employees or the operating overhead.

The parts that were written off were subsidized by the contracts from the private carriers.  Comparatively, Medicare pays the worst out of any health care carrier.  Many doctors don't even accept Medicare as a payor.  Good for them.  It pays about 60% of most other contracts for the CPT codes I bothered to compare against.

If you FORCE doctors to see patients that don't pay them and FORCE doctors to take a Medicare contract and FORBID them from taking private insurance in order to get their license to practice medicine, you will see a black market arise.  It will be cash based, and you will have to pay for medicine, and you will have to vette (sp?) your chosen health care provider very carefully to ensure he didn't print his degree on his home PC.
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Don't care

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Re: Universal Health Care
« Reply #77 on: November 19, 2008, 03:29:40 PM »
Yes, I used to be a DBA for a medical billing and records company.  I saw the contracts spiralling higher and higher in cost each year for each common procedure code, and I saw in my clients' databases the number of uninsured that were simply "written off."

But, the practice didn't "write off" the pay of their employees or the operating overhead.

The parts that were written off were subsidized by the contracts from the private carriers.  Comparatively, Medicare pays the worst out of any health care carrier.  Many doctors don't even accept Medicare as a payor.  Good for them.  It pays about 60% of most other contracts for the CPT codes I bothered to compare against.

If you FORCE doctors to see patients that don't pay them and FORCE doctors to take a Medicare contract and FORBID them from taking private insurance in order to get their license to practice medicine, you will see a black market arise.  It will be cash based, and you will have to pay for medicine, and you will have to vette (sp?) your chosen health care provider very carefully to ensure he didn't print his degree on his home PC.

I never said that physicians should see patients that wouldn't pay. Likewise, I never said that physicians shouldn't accept private insurance. Don't twist my words.

I merely stated that the method to getting rid of capitations, was to every Doc to accept a portion of indigent (now with basic health insurance) to treat as a CE to renewing their licenses. The fee-for-service would still be applied, without monies being given away for nothing done.

Just for the record, even private insurance doesn't pay 100% of a doc's billing. So public insurance's (Medicare and Medicaid) 60% isn't necessarily a bad thing either, as the 40% loss could be applied as a doc's corporate loss in the tax code.

ctdonath

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Re: Universal Health Care
« Reply #78 on: November 19, 2008, 03:56:25 PM »
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If health care is unaffordable to those without insurance

The basic premise there is faulty. The option is not black-and-white, best-care or no-care. The real fact is: you have a RANGE of care available to you, depending on what you want to spend. While it is standard practice for patients to do whatever the doctor recommends, and for the doctor to recommend the most thorough (read: expensive) options available, fact is people DO have the choice of saying "no, that's too expensive" and opting for other solutions. Yes, sometimes the choices may be hard because they are personal and painful; hard reality is that the care is not free and one does not have a right to compel others to pay for one's comfort.

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If you were debating the affordability of a 50" HDTV Sony, I would agree with you.

We are. Both contribute to "quality of life", and it's up to the individual to decide how much of their labors they wish to contribute to, and how, the extension and enjoyment of their own life. If you can afford a 50" HDTV, don't come demanding I pay for your stent which cost the same.
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Iain

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Re: Universal Health Care
« Reply #79 on: November 19, 2008, 04:18:22 PM »
We are. Both contribute to "quality of life",

Nonsense. One contributes to quality of life. The other means life or death to people, many of whom had absolutely no choice in the matter. Big difference.

Don't care - you're asking people to step away from fantasy and into reality. I suspect that is why no-one would address my situation directly in the other, recent thread.
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Headless Thompson Gunner

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Re: Universal Health Care
« Reply #80 on: November 19, 2008, 04:24:58 PM »

Don't care - you're asking people to step away from fantasy and into reality.
How do you figure that?  He's suggested that the government have the power to control how doctors spend their professional lives.  To justify this ugly idea, he uses the pseudo problem of capitation. 

Seems to me you have your notions of fantasy and reality backwards.

makattak

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Re: Universal Health Care
« Reply #81 on: November 19, 2008, 04:29:50 PM »
Nonsense. One contributes to quality of life. The other means life or death to people, many of whom had absolutely no choice in the matter. Big difference.

Don't care - you're asking people to step away from fantasy and into reality. I suspect that is why no-one would address my situation directly in the other, recent thread.

I went to see what you were talking about and I assume it was the question of how to deal with people with serious problems.

I did answer that: Aren't there charities for these sorts of things?

Perhaps you don't want to believe it, but Americans are very charitable people. Rather than using the government to steal someone else's life (money represents some portion of your life that you have spent EARNING it), why not ask people to pay for it?

Instead, it seems the ideas are to force someone else to pay for your support.


Simply because you use the government behind the gun doesn't make it any more righteous than if you club someone over the head and take their wallet.
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RoadKingLarry

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Re: Universal Health Care
« Reply #82 on: November 19, 2008, 04:33:40 PM »
In what world is it that people who actually produce/provide goods and services are expected to continue providing those goods and services at the point of a gun for incentive instead of being paid for their labor? Why would any sane person spend 8-10 years of their life, invest/borrow the $100s of thousands of dollars needed to become a doctor only to become a virtual slave of the state?
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Headless Thompson Gunner

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Re: Universal Health Care
« Reply #83 on: November 19, 2008, 04:35:09 PM »
In what world is it that people who actually produce/provide goods and services are expected to continue providing those goods and services at the point of a gun for incentive instead of being paid for their labor? Why would any sane person spend 8-10 years of their life, invest/borrow the $100s of thousands of dollars needed to become a doctor only to become a virtual slave of the state?
Bah.  That's just fantasy.  You need to step into reality.

Nitrogen

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Re: Universal Health Care
« Reply #84 on: November 19, 2008, 04:35:26 PM »
In what world is it that people who actually produce/provide goods and services are expected to continue providing those goods and services at the point of a gun for incentive instead of being paid for their labor? Why would any sane person spend 8-10 years of their life, invest/borrow the $100s of thousands of dollars needed to become a doctor only to become a virtual slave of the state?

Aren't lawyers required to do a certain amount of pro-bono work?  
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AZRedhawk44

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Re: Universal Health Care
« Reply #85 on: November 19, 2008, 04:36:21 PM »
Iain, where is your thread you're referencing?  I'm in the dark.
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Iain

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Re: Universal Health Care
« Reply #86 on: November 19, 2008, 05:08:34 PM »
Bah.  That's just fantasy.  You need to step into reality.

The fantasy is the trite Mel Gibson impersonation that seems to pass for serious debate on this, and other issues. Now let adults talk.

http://www.armedpolitesociety.com/index.php?topic=16044.0 - That's the previous topic. I welcome serious discussion about it, there may be answers and I'd really like to hear and understand them because it is entirely possible they are good answers. But I've raised this with people before, and aside from 'theft' 'thief' and said Mel Gibson impersonations few have ever addressed the serious underlying issues.

There are a lot of people like me in America. The only way I will ever be able to pay the full costs of my lifetime medical care needs is if I write something as successful as Harry Potter. In the next thirty years I could need three major organs transplanted. That's the downside of treating people like me with basic things like antibiotics - we live longer and cost more in the long run.

No-one seems to want to address the problem of those who have large medical needs they cannot afford, I suggested that we do on the previous page and no-one has. Could I keep going back to a specialist unit to get arguably non-absolutely-essential drugs, routine check-ups and scans - when that hospital knows that I cannot pay?

This is not about the ability to get patched up at the ER. This is about regular routine appointments, follow-ups investigations etc. I'll say this, and then I'd rather go back to generalities rather than personal issues - one consultant decided that my main condition did not adequately explain the seriousness of my state (multiple pneumonias, regular hospitalisation) So he looked, and looked and looked. And found a primary immune deficiency, or more accurately a marginal case for arguing that I had one. They treated that (at considerable expense) and the hospitalisations stopped, decline was arrested, even reversed and today I have a degree, a job and make a positive contribution to society. I'll never cover those costs though.

That's reality.
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Manedwolf

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Re: Universal Health Care
« Reply #87 on: November 19, 2008, 05:24:57 PM »
They treated that (at considerable expense) and the hospitalisations stopped, decline was arrested, even reversed and today I have a degree, a job and make a positive contribution to society. I'll never cover those costs though.

That's reality.

And who pays the doctor who has to pay the malpractice insurance costs and their student loans? Who pays the pharmas that developed and produce the medication? Who pays the R&D labs? Who pays the medical companies that developed the best way to stabilize those medications for delivery? Who pays the hospital's operating costs? Who pays?

ctdonath

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Re: Universal Health Care
« Reply #88 on: November 19, 2008, 05:26:31 PM »
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Nonsense. One contributes to quality of life. The other means life or death to people

Well, life/death is a rather important quality of life issue, isn't it? A biggie, ya think? Maybe people should put that $3700 toward their health care FIRST, instead of the HDTV and cable? And let's add up those other luxuries (bigger house, newer car, dining out, etc.) and see how much people can contribute to their own survival BEFORE just reaching into the pockets of others. We ARE talking life-and-death here, so how about individuals prioritize that before marginal/tangential quality-of-life luxuries.

And most of the time health care costs aren't a life/death binary choice, they're a shade-of-gray. Much of the cost goes to "let's rule out X" (and that largely to cover the doctor's butt, not yours), treatments to smooth out what would naturally heal anyway (you know it's the flu, no $200 doctor visit needed), and treating self-destructive behavior (your cigs and daily Cokes are your choice, not mine).

So let's get back to what the actual issue is: the chronically and/or desperately ill who really truly can't afford it and didn't bring it on themselves. Yes they warrant sympathy, and yes they are a tiny fraction of the citizenry of this nation. Arguably there is a gap, which does NOT require taking over the entire health care infrastructure which is working fine for most people, including those under Medicare, Medicaid, and walk-in ER types (who aren't going to do anything else anyway, even if free).

(And for something popped up after the above was written)
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No-one seems to want to address the problem of those who have large medical needs they cannot afford

We do. Problem from our angle is the pro-universal-free-care people keep spinning the few facing unaffordable needs into "the whole system is broken everybody is screwed let's socialize everything", which just derails the whole thing as the opposition rightfully sees it as theft.

Most people have the opportunity to get medical insurance - pricy, yes, but within their budget if only they would prioritize accordingly. Those who can and choose not to, well, at some point it you have to face the consequences of your own decisions. Get insured, stay insured, work hard, most conditions & illnesses will be covered. That takes care of the vast majority of individuals.

Next is the shade-of-gray scenarios. Certain treatments are desirable but not vital, so hard choices should be made - WITHOUT resorting to compelling others to pay it.

As noted above, that leaves a rather small percentage of people who truly need care and truly can't afford it. Much of that is already covered by Medicaid, Medicare, and ER - so there is really only a very small percentage that warrant charitable/taxpayer attention, like yourself. Given that gap in the system, let's see the real numbers on what closing that gap would cost - and NOT the $1T or so needed to cover everyone who currently is covered.

If we could limit the discussion to the actually needy, the discussion could progress to a viable solution.
Thing is, it keeps coming back to some form of me paying for the health costs of a cig-smoking chip-munching couch potato enjoying 40+ hours a week of an HDTV and cable TV service that frankly _I_ can't afford.

Drop the "universal" part of the argument. Most are doing fine with the system as-is.
Drop the "free" part of the argument. It's not free, it's freaking expensive.
Then we'll talk.

Quote
I'll never cover those costs though.

But you CAN contribute significantly to it. Just because you can't pay the whole bill now doesn't mean you hand the whole bill over to Joe Taxpayer, AND tack on the bills from people who CAN cover their costs. My bill was really high too - but I can manage to earn & contribute $10/day to it for life; no reason to stick Manedwolf with it.
« Last Edit: November 19, 2008, 05:33:31 PM by ctdonath »
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Headless Thompson Gunner

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Re: Universal Health Care
« Reply #89 on: November 19, 2008, 05:32:50 PM »
The fantasy is the trite Mel Gibson impersonation that seems to pass for serious debate on this, and other issues. Now let adults talk.

http://www.armedpolitesociety.com/index.php?topic=16044.0 - That's the previous topic. I welcome serious discussion about it, there may be answers and I'd really like to hear and understand them because it is entirely possible they are good answers. But I've raised this with people before, and aside from 'theft' 'thief' and said Mel Gibson impersonations few have ever addressed the serious underlying issues.

This is not about the ability to get patched up at the ER. This is about regular routine appointments, follow-ups investigations etc. I'll say this, and then I'd rather go back to generalities rather than personal issues - one consultant decided that my main condition did not adequately explain the seriousness of my state (multiple pneumonias, regular hospitalisation) So he looked, and looked and looked. And found a primary immune deficiency, or more accurately a marginal case for arguing that I had one. They treated that (at considerable expense) and the hospitalisations stopped, decline was arrested, even reversed and today I have a degree, a job and make a positive contribution to society. I'll never cover those costs though.

That's reality.

I'm sorry if you feel that we've neglected this issue in the past when you brought it up.  It's just that this sort of thing is common sense, and I think most of us don't feel the need to dwell on it.

It's basic economics, Iain.  It's a problem of limited resources.  It simply isn't possible for everyone to consume more resources (medical or otherwise) than they've produced.  

It's possible for one person to consume more than he's produced if there are other producers making up the difference.  That's the situation you describe yourself in.  You've consumed medical resources beyond your ability to produce.  It worked because there was someone else out there who produced more than they consumed and shared their excess with you.

That solution works on a small scale, so long as there are many more excess-producers than there are excess-consumers.  That's how insurance works.  It's a great system whenever the odds of a major costly operation are low.  But if that balance shifts, if there are more excess-consumers than excess-producers, then the system falls apart.  Resources have to be produced before they can be consumed, and if there aren't enough being produced then it just isn't possible for everyone to consume them.

If it becomes probable that everyone will need major costly medical services in their lifetimes, beyond their ability to pay, then the system becomes untenable.  Even if you believe that major, costly medical procedures are a fundamental right, the system just isn't possible.  Making it a right doesn't magically mean there are enough doctors and hospital beds and medicines to go around.  Those are all economic resources, they have to be produced in the economy, and there is a limit to our productive capacity. 

That's the fundamental problem with universal health care.  It promises to let everyone consume more than they produce.  Obviously that isn't possible, but that doesn't stop politicians from promising it.

Politicians can promise to give these things to us all, but they can't make those things exist to be given in the first place.

« Last Edit: November 19, 2008, 07:20:48 PM by Headless Thompson Gunner »

ctdonath

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Re: Universal Health Care
« Reply #90 on: November 19, 2008, 05:39:19 PM »
Worth repeating:
Quote
I'm sorry if you feel that we've neglected this issue in the past when you brought it up.  It's just that this sort of thing is common sense, and I think most of us don't feel the need to dwell on it.
We're not heartless. We just realize there are limits in the system, and limits to our own wallets.
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Iain

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Re: Universal Health Care
« Reply #91 on: November 19, 2008, 05:51:18 PM »
I don't have time now, but I'll say quickly - I'm not arguing in favour of universal health care necessarily. I'm arguing that crying 'freedom' and saying that we don't want to pay for others costs is not a comprehensive answer to a complex issue, which I agree is not what all of you are saying. More another time.
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Boomhauer

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Re: Universal Health Care
« Reply #92 on: November 19, 2008, 06:08:21 PM »
Aren't lawyers required to do a certain amount of pro-bono work? 

A quick search on Wikipedia turns up that lawyers are reccommended to contribute 50 hours of pro-bono service per year by the American Bar Association. Some law school apparently require some pro-bono service.

If it was me, I sure as hell wouldn't do any pro-bono work. I don't get paid, I don't do any work. Simple as that.

(Oh, and the word to define requiring work without pay...that's slavery)

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Headless Thompson Gunner

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Re: Universal Health Care
« Reply #93 on: November 19, 2008, 06:08:43 PM »
I don't have time now, but I'll say quickly - I'm not arguing in favour of universal health care necessarily. I'm arguing that crying 'freedom' and saying that we don't want to pay for others costs is not a comprehensive answer to a complex issue, which I agree is not what all of you are saying. More another time.
Freedom is a comprehensive answer to this issue.  And the issue is really quite simple.  There two parts to the problem.  One is limited resources, and the other incentives.  Freedom solves both of those problems.  But I agree, more another time.

Jamisjockey

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Re: Universal Health Care
« Reply #94 on: November 19, 2008, 06:14:15 PM »
an Iphone costs about 1,200/year.
Insurance costs about 12,000 a year.

Where in the hell did you get that number from?
We just insured our family for about $312 a month, which is about $3150 a year.  Family of four, I have high cholesterol and we've all had at least one surgery. 

Oh, and we are paying for it ourselves.  It is not a plan through an employer.
« Last Edit: November 19, 2008, 06:27:44 PM by JamisJockey »
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Headless Thompson Gunner

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Re: Universal Health Care
« Reply #95 on: November 19, 2008, 06:23:54 PM »
My health insurance costs $315 a month, and it covers myself and my wife.

Don't care

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Re: Universal Health Care
« Reply #96 on: November 19, 2008, 06:36:24 PM »
To justify this ugly idea, he uses the pseudo problem of capitation.

If you believe that capitation, one among many others, is only a pseudo problem, then your idea of reality and fantasy deserve closer scrutiny.

I hope your insurance plan has a good psych rider.

De Selby

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Re: Universal Health Care
« Reply #97 on: November 19, 2008, 06:45:17 PM »
Aren't lawyers required to do a certain amount of pro-bono work?  

Generally not, but their fees are more or less set in stone.
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De Selby

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Re: Universal Health Care
« Reply #98 on: November 19, 2008, 06:57:28 PM »
Definition of irony:  Bunch of employees of the government complaining that government doesn't work, and that no doctors will want to work for the government.

Jamis, as you well know, coverage like that at your price is the exception, not the rule.  Nitro's number is accurate for the average.  And then there's this problem:  If the breadwinner paying the 315 goes out of work, how can the insurance remain available for any significant period of time?

The puzzling thing is this:  per capita, the US spends way more on healthcare than any other country in the world.  Yet, other countries manage to cover the entire population, and receive equivalent per capita levels of service and amounts of service.

So even though were we to simply copy one of the socialist medicine systems, it would cost less per person and we'd receive basically the same care, that's a horrible thing because....it's against freedom.

"Freedom" is going to be a dirty word within a generation if it's held responsible for maintaining outrageous prices for medicine, and denying treatment to millions of people. 

I suggest that as a movement, pro-freedom conservative thought should take its battle elsewhere, or the 40 million voters (and increasing) with no insurance, and the roughly 30 percent of insured who can't afford decent coverage, are going to vote it out of existence.
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Boomhauer

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Re: Universal Health Care
« Reply #99 on: November 19, 2008, 07:07:59 PM »
Quote
Definition of irony:  Bunch of employees of the government complaining that government doesn't work

It's not irony...it's the truth.

You think I like working for the government? I DON'T. It's soul sucking. But, I had a unique opportunity to take a unique job that few others will see that will be one hell of a part time job when I put it on my resume.

But the people I work with...you would be an IDIOT to want them to have anything to do with your healthcare.

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