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Old 08-17-2017, 12:01 PM
 
5,102 posts, read 2,737,266 times
Reputation: 4642

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Quote:
Originally Posted by TheFlats View Post
Who is talking about the government allocating (?) scare resources? Is the point that Medicare should use dollars spent on healthcare to tackle fraud? Is it that the government shouldn't give Medicare more resources to tackle fraud since they'll be misused to pay government salaries? Is is that health care is a scare resource? Which is why people in Germany have such a hard time finding medical care, right?

Yeah just take reality out of it and assume we all live in a happy, peaceful world where everyone is rational and charitable and Austrian economics works just fine. Sounds a bunch like communism right Cali?
You're missing her point (thanks for correcting me on her gender).

All problems being discussed (food, health care, etc) have the same problem which is scarcity. Government is extremely bad, compared to the free market, of solving the problem of scarcity because it's built to create it. Taxes, regulation, legislation all create scarcity in some way (unless they are created with giving the market more freedom which almost never happens, that's why they are called regulations).

Giving more money to Medicare to supposedly solve it's waste and fraud doesn't solve the actual problem, why the fraud and waste occurs in the first place.

Why do you think it occurs? If you can answer that problem correctly, then you'll see why K-12 Public schooling, Social Security, and MediCare have never, ever met the expectations of its original goals.

 
Old 08-17-2017, 12:57 PM
 
Location: Paranoid State
13,047 posts, read 10,390,825 times
Reputation: 15672
Quote:
Originally Posted by SportyandMisty View Post
Economists on the left, right and center all agree on one thing: government is exceptionally good at creating shortages and scarcity. For example, if the government passes a law or implements a regulation limiting the price of tomatoes to 2 cents per pound, very rapidly we would have a nationwide shortage of tomatoes.
Quote:
Originally Posted by TheFlats View Post
Nobody is talking about price controls for food (let's get rid of those corn/ethanol subsidies though). Geez, y'all are like a bunch of wandering kittens, stay on topic haha.

My bad: I have a tendency to use too many analogies. I chose the market for tomatoes precisely because the example is illustrative and obvious, whereas the costs and the prices of medical care are frequently obscure.

My point was that just as a price ceiling for a commodity (tomatoes) creates a shortage, so also does a price cap on a medical service (the cap as determine by CMS) creates a shortage. In the case of Medicaid/Medicare, that shortage shows up in several ways. It can be quite difficult to find a physician who accepts new medicaid/medicare patients because of the cap on the price the physician can charge CMS. Those physicians who do indeed continue to treat Medicaid/Medicare patients even though they are strictly speaking a money losing proposition fund the shortfall by "squeezing the balloon." Sorry for that analogy as well. Squeezing the balloon occurs when they charge more for elsewhere to make up for the shortfall in Medicaid/Medicare.

The easiest example to see of this phenomenon is the $100 aspirin at a hospital. The hospital's price for the aspirin is $100 even though its cost is a penny (if that). Why? The hospital is looking at TOTAL revenue generated from all sources and TOTAL costs from all sources. Because Medicaid/Medicare price ceilings exist, compensating the hospital less, the hospital responds by "squeezing the balloon" and inflating the price of that aspirin to $100.

Again, by analogy (sorry) we have to find a way to remove some of the air from the balloon -- that is, somehow drive down the aggregate costs of medical care across the board. Currently, the aggregate medical care costs are about $10,000 to $12,000 per person on average. We need to find ways to drive that down to, say, $5,000 to $6,000 per person on average. Then it approximates affordability.
 
Old 08-17-2017, 01:05 PM
 
655 posts, read 468,124 times
Reputation: 824
I understand analogies. Tomatoes are not really analogous to health care.

It seems you have an issue with negotiated rates for services (different than a price cap a la tomatoes)? Should Medicare not negotiate with providers and set reimbursement limits for care? Or is the issue that hospitals are free to charge individuals and private insurance companies more for procedures than they would bill Medicare?

If a doctor is losing money providing care to Medicare patients they can stop providing care, they're not obligated to accept those patients and many don't. The government isn't forcing them to deliver care. Are you saying Medicare should have higher reimbursement rates?

Quote:
Originally Posted by expatCA View Post
Humm, maybe he is a troll?

Likes fires and that is why he likes CA?
Hahaha silly me liking California.
 
Old 08-17-2017, 01:36 PM
 
17,464 posts, read 10,543,878 times
Reputation: 8361
Quote:
Originally Posted by TheFlats View Post



Hahaha silly me liking California.
Gotta have a little humor here at times.

I was born and raised in SoCal and love it, just hate a lot of the things that have happened. Might move back, might not.

Doctors and hospitals are basically in business to make money. That is the primary goal anymore, with very few exceptions. Medicare is helpful to those of us on it in many ways, but the lower payments end up being offset by higher costs for everyone else. Now in reality the doctors and hospitals would still make money if everyone was on Medicare and all doctors and hospitals had to meet the prices set and they all had to accept any medicare patient that came to them, but could charge more for those with additional private insurance.

In seeing my doctor I see there is another alternative. Doctors in family practice hardly spend more than a couple of minutes with a patient and many times are not really needed. Establish a program for Medics, Nurses, etc to handle the easy cases and the tougher ones go to doctors. Mind you I like my doctor and we discuss a lot of medical things, but I do not need to see him 95% of the time I am there. This would lower costs as well. Of course he might not like my seeing others and he gets no pay for it.
 
Old 08-17-2017, 02:30 PM
 
655 posts, read 468,124 times
Reputation: 824
I agree and that's why we're seeing the rise of nurse practitioners and physician's assistants. Heck with Kaiser you can email your doctor, call the 24/7 nurse line with questions, or even instant message them. One of the best things we can do to control the root costs of care is to stop so many folks from coming into emergency rooms for everything.
 
Old 08-17-2017, 03:41 PM
 
Location: So Ca
15,673 posts, read 14,928,270 times
Reputation: 13604
Quote:
Originally Posted by TheFlats View Post
I understand analogies. Tomatoes are not really analogous to health care.
Exactly.

Quote:
Originally Posted by CaliRestoration View Post
All problems being discussed (food, health care, etc) have the same problem which is scarcity .
No, food and health care do not "have the same problem." Health care is not a commodity. There is no "free market" with health care.

https://www.forbes.com/sites/chrisla.../#69fac8c21147
 
Old 08-17-2017, 03:47 PM
 
5,102 posts, read 2,737,266 times
Reputation: 4642
Quote:
Originally Posted by CA4Now View Post
Health care is not a commodity.
But it is a service, and one that is not unlimited, so it is subject to scarcity (e.g - Canada wait times to see specialist, etc). This is a very basic fact of socialized healthcare.
 
Old 08-17-2017, 04:51 PM
 
655 posts, read 468,124 times
Reputation: 824
What's a basic fact of socialized health care? That it somehow causes less doctors to exist than a fully privatized insurance system or everybody paying fee for service? I don't understand your point.

Yes, there is not an unlimited supply of doctors, no one was arguing otherwise. Specialist wait times in Canada are for things like liver transplants that have waiting times here too. Canada has much better health care outcomes than the US so it's not like people aren't receiving care they need.

Try finding decent, affordable healthcare in a free market if you live in a rural area. Scarcity exists. Government creating it? Eh, you haven't done a good job of explaining yourself on that one.
 
Old 08-17-2017, 05:28 PM
 
5,102 posts, read 2,737,266 times
Reputation: 4642
Quote:
Originally Posted by TheFlats View Post
Specialist wait times in Canada are for things like liver transplants that have waiting times here too.
No, that is totally incorrect.

Here are the wait times for various specialist in Canada by category.

In weeks:

Neurosurgery: 46.9
Orthopaedic surgery: 38
Ophthalmology: 28.5
Plastic Surgery: 25.9
Otolaryngology: 22.7
Gynaecology: 18.8
Urology: 16.2
Internal medicine: 12.9
Radiation oncology: 4.1
General surgery: 12.1
Cardiovascular: 8.4
Medical oncology: 3.7

That's called rationing, and it's what happens with socialized healthcare. Governments do not solve the problem of scarcity better than free markets.

Quote:
Canada has much better health care outcomes than the US so it's not like people aren't receiving care they need.
That's is again incorrect. You really should research before you make statements. The most comprehensive study ever done by NIMH about healthcare outcomes found negligible difference between outcomes in the U.S and Canadian healthcare systems. What they did find however was in the U.S the cost were 33% higher.

Quote:
A systematic review of studies comparing health outcomes in Canada and the United States

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2801918/

"Canada’s single-payer system, which relies on not-for-profit delivery, achieves health outcomes that are at least equal to those in the United States at two-thirds the cost."
The reason there is a difference in cost is because single payer in Canada sets strict price controls across the board for both treatment and pharma (not so in the U.S). Plus U.S doctors make dramatically more money than their Canadian counterparts.

http://nationalpost.com/news/canada/...8-f066f124797f

Quote:
The average income after expenses, in U.S. dollars, for an orthopedic surgeon in the U.S. was $442,450, compared to $208,000 in Canada, $324,000 in the U.K. and $154,000 in France.
So if you want to have a conversation about "I don't think U.S doctors should make so much money", that's a different discussion than "Canada has much better health care outcomes than the US" which is blatantly false and has been debunked by NIMH.

Last edited by CaliRestoration; 08-17-2017 at 05:50 PM..
 
Old 08-17-2017, 05:45 PM
 
655 posts, read 468,124 times
Reputation: 824
You're right, Canada has long waiting times for care compared to others. Some of the shortest wait times are in countries with socialized healthcare though, why is that?

Do you believe that if an American cannot afford healthcare they should not get care? Do you believe Medicare should exist?

Edit: Your NIH study is based on patients that have undergone treatment. Many in the US avoid treatment for various ailments because they cannot afford the care. Apples to oranges. Besides, the study essentially boils down to "roughly similar outcomes, higher costs for the US."

Quote:
Originally Posted by NIH Study
In this systematic review, we demonstrated that although Canadian outcomes were more often superior to US outcomes than the reverse, neither the United States nor Canada can claim hegemony in terms of quality of medical care and the resultant patient-important outcomes.
Quote:
Originally Posted by NIH Study
These studies raise another important limitation of the current data. Canada has largely (though not completely) eliminated gradients in access to care by socioeconomic status that remain in the United States, and this may contribute to Canada’s smaller socioeconomic gradients in health outcome. If this were so, one would expect that studies focused on poorer individuals would reveal superior outcomes in Canada, whereas differences might be obscured in studies of entire populations.

Last edited by TheFlats; 08-17-2017 at 06:12 PM..
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