So Virginia bans O-Care

[kronus]

I had very, very special circumstances.

They weren't special circumstances. They were to you, yes, and most people don't go through that. However, they were not by any distance special circumstances to the medical care facilities that treated you. "Someone paid" is shortsighted. Realistically, the hospital had to absorb the cost by suing another patient for their unpaid bills and jacking up insco prices on services, and this happens every day.

If you didn't know, ERs and other treatment centers have an "insured" price and a "uninsured" price. One of my close friends tore her meniscus and had to go to the ER for a cast and crutches. When they found out she didn't have insurance, $200 crutches magically became $20 crutches, and other costs dropped astronomically or disappeared. Basically, to make up for people who can't pay bills at all, the hospital adds on charges to people who have insurance, which in turn raises insurance rates. I don't see a way private, free-market insurance can remedy this.

[ck_taft325is]

I see what you're saying. But I still don't see how Government can solve this?

[KenC]

I never claimed to be an expert. Are you one? If so, enlighten me. I'm up for learning ;) And if I'm incorrect, point me in the right direction. Not your opinion or belief, but a fact that I've mistakenly misunderstood or just flat out didn't understand.

Being an expert and being able to spot a blatant lie are very far apart.

As one who plans on devoting their life to the field (I'll be notified of my acceptance status in 4-6weeks), I tend to stay informed on the issues. That and working 50+ hours/week in the field (actually in the hospital now), as well as shadowing different physicians on a weekly basis gives me pretty good insight into how things work.

You stated that government influence and insurance companies are to blame for high prices. What exactly do you mean by that?

We both agree that tort reform is necessary, however, you seem a bit too hopeful on how much it could lower overall costs. The CBO estimates $5.4billion per year. We spent $3.2trillion in 2009. Drop in the bucket, metaphorically speaking.

Medicine is too unpredictable to be able to assembly line every hospital and completely standardize care. There's an analogy that I wrote in the other thread regarding it.

[KenC]

I see what you're saying. But I still don't see how Government can solve this?

Insurance mandates. When everyone has it, hospitals don't have to inflate their costs enormously to compensate for all of the charitable care for the uninsured who can't pay out of pocket. It's like car insurance... if you can prove $2m in assets, then insure yourself, otherwise you better have insurance.

[ck_taft325is]

Insurance mandates. When everyone has it, hospitals don't have to inflate their costs enormously to compensate for all of the charitable care for the uninsured who can't pay out of pocket. It's like car insurance... if you can prove $2m in assets, then insure yourself, otherwise you better have insurance.

Question for this... when it's mandated, how will those that can't already pay H.I. afford it suddenly?

[mrsleeve]

They weren't special circumstances. They were to you, yes, and most people don't go through that. However, they were not by any distance special circumstances to the medical care facilities that treated you. "Someone paid" is shortsighted. Realistically, the hospital had to absorb the cost by suing another patient for their unpaid bills and jacking up insco prices on services, and this happens every day.

If you didn't know, ERs and other treatment centers have an "insured" price and a "uninsured" price. One of my close friends tore her meniscus and had to go to the ER for a cast and crutches. When they found out she didn't have insurance, $200 crutches magically became $20 crutches, and other costs dropped astronomically or disappeared. Basically, to make up for people who can't pay bills at all, the hospital adds on charges to people who have insurance, which in turn raises insurance rates. I don't see a way private, free-market insurance can remedy this.

This is also thanks to the Govt getting involved oh so long ago with the medicare/medicaid and not paying enough to even cover the costs of the procedure. Where do you think the H.I. companies base what they want to pay for services off of???

Less govt is a good thing not more of it.

[kronus]

Less govt is a good thing not more of it.

Your problem is that you take this statement as holy scripture and derive your other opinions from it.

How does Medicare/Medicaid influence private insurance providers, exactly?

[ck_taft325is]

From what my wife (RN) has experienced it goes something like this...

Medicare only pays a certain set amount, which is lower than actual costs of say a retirement home to run. So, in turn they pass on the extra added costs/deficits onto those paying out of retirement funds or those that have insurance. Which raise rates, i.e. cost of insurance etc, etc...

This is not a blanket covering example, but what we've been discussing. Thoughts, KenC?

[KenC]

Question for this... when it's mandated, how will those that can't already pay H.I. afford it suddenly?

Subsidies.

[ck_taft325is]

Subsidies.

So taxation of those that make more? This so far is my only rub. The seeming way in which nationalized health care can succeed is to tax at a percentage of your income, which is effectively stealing from someone to give to someone else? Correct me if I'm wrong.

[KenC]

From what my wife (RN) has experienced it goes something like this...

Medicare only pays a certain set amount, which is lower than actual costs of say a retirement home to run. So, in turn they pass on the extra added costs/deficits onto those paying out of retirement funds or those that have insurance. Which raise rates, i.e. cost of insurance etc, etc...

This is not a blanket covering example, but what we've been discussing. Thoughts, KenC?

Medicare/Medicaid pay pretty damn close to most places "bottom line." They have a set amount of money to work with, and ration it accordingly.
Nursing homes/skilled-nursing centers make ASS-LOADS of profit.

[kronus]

So taxation of those that make more? This so far is my only rub. The seeming way in which nationalized health care can succeed is to tax at a percentage of your income, which is effectively stealing from someone to give to someone else? Correct me if I'm wrong.

The rich are not taxed at a percentage - the way this is typically done is via a tax exemption that people not in a nationalized health program do not qualify for. So, yes, the rich pay more, but no, not as a percentage of their income.

This argument confuses me, though. When you pay car insurance, regardless of how wealthy you are, your money goes to pay for someone else's fuckups. People with more expensive liability plans (highly correlated with wealthier people) pay more than people with cheaper plans for these fuckups. Nobody seems to have a problem with this.

[mrsleeve]

they wealthy pay more in liability not because they can afford to, its because the asset they are insuring COSTS MORE.

Poor person drives 1997 Buick regal that costs 800 year to insure, Wealthy person drives a 2010 BMW 335I, which one costs more to fix, buy, and replace?????? They pay more because they have shit that costs more in general. (this is assuming that both the poor person and the wealthy person have similar driving records )

Eg. 2) Poor person lives in a 1979 Holiday rambler single wide with nothing of real value in it. Wealthy person lives in a Nice 3000sq/ft custom home full of nice furnishings, jewlery, cars and tools in the garage, blah blah blah, Which one of those deals will cost more to replace and fix if some thing happens

You get a premium based on the value and cost to fix or repair the asset being insured not based on how wealthy you are. Come on you know this

Your problem is that you take this statement as holy scripture and derive your other opinions from it.

How does Medicare/Medicaid influence private insurance providers, exactly?

Yes I value freedom and feel that small and less intrusive govt is good for all. I guess that makes me weird


THE MEDI's payments in most instances are 1 slow and 2 not enough to cover the raw cost of the services/procedure rendered. For a Care facility to be eligible for public dollars/grants for up grades, new technology, new/improved facilities, etc... they have to take MEDI patients, there for have to take what ever the govt will pay for those services.

Now the private H.I. industry uses the govt MEDI programs payment scale as a bench mark for their own negotiated rates (they dont get it but thats what they shoot for).

So thanks to govt intrusion and not paying its way H.C. providers must jack the rates to both the private H.I. companies and walk in retail pay their own way customers to recoup the losses form all the Medi patients. They have to inflate the cost that they show the H.I. companies so the new negotiated price will still allow them to make enough money to keep the lights on, make up the diff for all the those that cant pay and the Medis short payment.

This has all lead to the explosion of H.C. costs, you can thank the Govt for it as it is now, and you want to give total control of the system they fucked up in the 1st place and think the result will be different????? Or even different than what has happend in ever other country that has tried it?????

[ck_taft325is]

To some degree, I understand what you're saying. Car insurance differs in that if you're a responsible driver, with no tickets or accidents, your rates are not higher than say, someone that's irresponsible. To make a broad generalization of wealthy people, aren't they *normally* insuring more expensive vehicles? Continueing this a bit, it would be silly to insure a beat to crap Toyota Tercell (one of my first cars... /gag) with full coverage while getting basic on a $100,000 + Bentley, yes?

But I see what you mean that the Tercell gets totalled and ruins another car for say, $40,000 in damages but has only been paying $40 a month while the wealthy person spends upwards of say, $300 a month for full coverage. I'm just trying to be totally clear.

How are the wealthy taxed in this proposed plan? I can't track down an honest recounting of what's in the bill, but then again, I'll be 100% honest and say I haven't looked very hard.

[KenC]

So taxation of those that make more? This so far is my only rub. The seeming way in which nationalized health care can succeed is to tax at a percentage of your income, which is effectively stealing from someone to give to someone else? Correct me if I'm wrong.

In so many words, yes. And this is PRECISELY the philosophical gap between the two sides that will never be bridged at any summit.

We can try and try to make healthcare affordable for all, but I personally don't see it as a possibility... at least at the level that would precipitate a "healthy" society. Should society fill that gap (through taxes)?

It's a personal position of social obligation.

Income/wealth isn't always directly correlated to how hard one works. It's unfortunate that it often times dictates ones quality of life.