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Old 10-20-2017, 10:43 AM
 
17,457 posts, read 10,539,112 times
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Quote:
Originally Posted by SportyandMisty View Post
Very true -- that is part of the long-term decline in the productivity of health care. One might think a government-based single payer system would have less bureaucracy than insurance companies, but the history of government flies in the face of that hope.
Yes, look how well the union controlled State and Municipality departments work and how they are saving money.

Private companies pay profit to Directors and Officers as well as stockholders and investigator.

Gov't run "business" pay that to the Politicians, union officers, pensions, in contributions, political advertising and even keep less than efficient employees on at maximum pay. In effect no money is saved either way.

Businesses get rid of employees, even directors and officers, who do not run things well and end up costing the business too much money. Gov't never gets rid of anyone not running it well. In CA the voters don't either.

Last edited by expatCA; 10-20-2017 at 10:54 AM..

 
Old 10-20-2017, 10:45 AM
 
655 posts, read 467,947 times
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Quote:
Originally Posted by expatCA View Post
Mine too, so I am also helping someone else by paying for theirs and I am not complaining about it. And I still pay hundreds of dollars every month in Medicare insurance including both parts AND payroll taxes as well, which also goes to help others.
So are you OK with the aspect of the ACA that provides government subsidies to buy health insurance for people with lower incomes?

Quote:
Originally Posted by SportyandMisty View Post
Of course the not-ACA is the problem. It did nothing to address the root cause that the underlying price of health care services is too damn high -- that's why it is a problem.
So would you be OK with the government and the healthcare providers regularly negotiating the accepted rates for various medical procedures? That's what other countries do to contain the core costs of delivering healthcare.

Quote:
Originally Posted by SportyandMisty View Post
In this country people consume $10,000 per year of health care services -- therefore the insurance must cost $10,000 per year plus administrative overhead plus profit. There just is now way to get around the arithmetic on that. So, the only way to make things affordable is to change that $10K per person per year in health care services. If it were driven down to $5,000 per person per year, then the insurance would drop to $5,000 per person per year plus administrative overhead plus profit.
One way to get around the arithmetic of high administrative costs is to eliminate necessary layers of bureaucracy and a patchwork of cost/payment structures. Other countries do it with less of a percentage of their economy spent on healthcare, why can't we? It's not impossible Sporty.
 
Old 10-20-2017, 10:48 AM
 
Location: Paranoid State
13,047 posts, read 10,388,128 times
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Quote:
Originally Posted by CA4Now View Post
Medicare recipients don't receive health care for nothing; not only have they paid into it, they pay a monthly amount based on their income.
But clearly the monthly medicare premium is too low to cover the cost of providing the service.

Seniors on Medicare consume north of $20,000 per person per year in actual medical costs. So, medicare premiums need to go up to cover that amount of medical care.

Of course, that isn't feasible, so the overage is paid for by other people -- those still working.
 
Old 10-20-2017, 10:49 AM
 
655 posts, read 467,947 times
Reputation: 824
Quote:
Originally Posted by expatCA View Post
Yes, look how well the union controlled State and Municipality departments work and how they are saving money.
Honestly public utilities are usually better run and cost ratepayers less than the PG&E types. They only have a single regulator in the federal government without middleman state regulation so it cuts through significant bureaucracy.

Germany's heavily unionized auto industry seems to be doing just fine.

But again, this is just another example of complaining without solutions. Whine whine whine, we've heard it all before.
 
Old 10-20-2017, 11:48 AM
 
Location: Paranoid State
13,047 posts, read 10,388,128 times
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Quote:
Originally Posted by TheFlats View Post
So would you be OK with the government and the healthcare providers regularly negotiating the accepted rates for various medical procedures? That's what other countries do to contain the core costs of delivering healthcare.
At this point, our system is so screwed up I honestly don't know where to begin to fix it. Your idea is at least as good as any I've seen, and deserves a shot. We could start with the prices used by other countries as a starting point.

I still note that LASIK is an example of where there is no insurance involvement and the quality has improved while the price has plummeted. I would love to see expansion of the LASIK model to other things, but we have to be EXTREMELY selective. Consumers always have a choice to not buy LASIK because they can instead wear glasses or contact lenses. That is not true with trauma surgery, for example.

Quote:
Originally Posted by TheFlats View Post
One way to get around the arithmetic of high administrative costs is to eliminate necessary layers of bureaucracy and a patchwork of cost/payment structures. Other countries do it with less of a percentage of their economy spent on healthcare, why can't we? It's not impossible Sporty.
I'll agree it is not impossible -- just very difficult. We should still try. Governments are not good at removing layers of bureaucracy. After all, each and every layer is someone's livelihood.
 
Old 10-20-2017, 11:55 AM
 
655 posts, read 467,947 times
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Governments are us, we can do it. Just takes some political will. We absolutely can and should make a bipartisan push for reforming our civil institutions but it has to be done in good faith.

There is a balance to things and sometimes its choosing the least bad option. Yes, we should negotiate with drug companies to bring down the cost of prescription medication but we can't be so cheap or restrictive as to cut off R&D and stifle the robust drug industry we have in America.

Complicated stuff but I think we should be able to agree on the basic philosophical issues like every American being deserving of affordable healthcare.
 
Old 10-20-2017, 12:34 PM
 
5,099 posts, read 2,734,547 times
Reputation: 4642
Quote:
Originally Posted by CA4Now View Post

Dirty little secret: Insurers actually are making a mint from Obamacare:
Dirty little secret: Insurers actually are making a mint from Obamacare - LA Times
Hmm that doesn't make sense. If they're making such a "mint", then why are they jumping out?

Do companies usually run away from making lots of money? That doesn't seem logical. Care to explain?
 
Old 10-20-2017, 12:54 PM
 
Location: Living rent free in your head
30,908 posts, read 13,475,609 times
Reputation: 22024
Quote:
Originally Posted by SportyandMisty View Post
I still note that LASIK is an example of where there is no insurance involvement and the quality has improved while the price has plummeted. I would love to see expansion of the LASIK model to other things, but we have to be EXTREMELY selective. Consumers always have a choice to not buy LASIK because they can instead wear glasses or contact lenses. That is not true with trauma surgery, for example.
Competition is not the only reason why the price of lasik has plummeted, it is also far less popular than it once was:

"Potential patients are less likely to opt for Lasik than in the procedure's heyday of 2000-2007, when ads flooded the airwaves and more than a million of the outpatient surgeries were performed each year. The number of laser vision correction surgeries per year a category including Lasik and the closely related PRK procedure has dropped more than 50 percent, from about 1.5 million surgeries in 2007 to 604,000 in 2015, according to the eye care data source Market Scope."
Lasik surgery falling out of favor with patients - Chicago Tribune
 
Old 10-20-2017, 01:18 PM
 
Location: Paranoid State
13,047 posts, read 10,388,128 times
Reputation: 15672
Quote:
Originally Posted by TheFlats View Post
Complicated stuff but I think we should be able to agree on the basic philosophical issues like every American being deserving of affordable healthcare.
One of the surviving victims of the Las Vegas Massacre is a case in point.

She has no medical insurance because she says it is too expensive. But she has a new $70,000 pickup truck. And she travels to music festivals about 10x per year.

In her case, she could purchase medical insurance - but she chose not to because she would rather spend her scarce money on the trucks & vacations, & music festivals. She is still in the hospital. She wasn't shot, but she was trampled. She's slowly regaining the use of her left side.

There are two primary ways to obtain the affordable healthcare of which you think every American is deserving.

One is to subsidize its purchase -- that is, have other people pay for it. In the short run, that's all we can do, but in the long run this method fails.

The other is to drive unproductive costs out of the system so more people can afford to buy it. You can't accomplish this in the short run, but it is the only long-run solution possible.
 
Old 10-20-2017, 01:20 PM
 
Location: Paranoid State
13,047 posts, read 10,388,128 times
Reputation: 15672
Quote:
Originally Posted by 2sleepy View Post
Competition is not the only reason why the price of lasik has plummeted, it is also far less popular than it once was:

"Potential patients are less likely to opt for Lasik than in the procedure's heyday of 2000-2007, when ads flooded the airwaves and more than a million of the outpatient surgeries were performed each year. The number of laser vision correction surgeries per year a category including Lasik and the closely related PRK procedure has dropped more than 50 percent, from about 1.5 million surgeries in 2007 to 604,000 in 2015, according to the eye care data source Market Scope."
Lasik surgery falling out of favor with patients - Chicago Tribune
A funny thing about LASIK: once you treat a patient, that patient doesn't need anymore treatment (except in rare cases). It makes sense the total number of surgeries performed per year has gone down because the total number of people who have not been treated keeps going down. Perhaps we are at a steady state where the number of procedures performed is mostly explained by younger adults moving into full adulthood.

At the same time, the price of LASIK and PRK have indeed plummeted. And the quality has gone up.
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