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Why is use of an OR for a few hours $64,000? That is the question.
And it has an incredibly simple answer... because it can. Part of the answer is that doctors and hospitals are so burdened with rules, regulations, fees, paperwork, red tape, and bureaucracy and malpractice insurance that they must charge much higher prices to recoup those costs. But the main answer is, because we have come to believe that it's a good idea to divorce the consumer of this service (health care) from who pays, literally nobody cares about how much it is. The insurance companies don't care, they pay a fraction anyway, and can always charge higher premiums. The hospitals don't care because no matter if that bill ever gets paid, in part or in full, huge amounts of money are rolling in the door. And the patient doesn't care, because they expect and believe that they shouldn't have to pay for health care.
The best thing we could do to actually reform health care would be A) true malpractice reform, where malpractice is only found in the case where the provider was truly negligent and not just that there was an outcome someone was unhappy with; and B) ban health insurance other than catastrophic care policies. Yes, really... if we got back to everyone expected to pay their bills in full at the time of service, and not with "other people's money", we'd all start to care what those bills were, and providers could not charge prices that nobody could pay. Sixty years ago, this is what we had... you saw the doctor, you paid, and you didn't have to mortgage everything in your life for one night in the hospital.
But most people believe they have some kind of right to receive health care services without paying anything, so our system will continue to get worse and worse until it breaks. At least Europeans are willing to pay the massive tax burden for their "free" health care... we aren't.
If Healthcare on the provider end were the license to print money as some believe how can the never ending stream of Hospital closing be explained across the country?
In my area... there was a hospital that met earthquake requirements and had a high patient census...
Problem is the patients were overwhelming not insured or under insured...
The Not for Profit Parent Company sold the entire Hospital for $1 to the County just to get out... plus forgave millions in debt...
Now the county has a constant battle for funding... not because the hospital isn't good or needed... simply because the cost at a county owned facility is near insurmountable... again... the entire Hospital and Land, etc... was basically a gift.
You have to read it in the context of the discussion. In this case, it was a poster who stated he thought people who didn't live a healthy lifestyle (in his opinion) should not have the same access to health care as those who have, again in his opinion, "better" behavior. My point was it's not that easy and it's not always about choices, it's about life circumstances, access to health care, and genetics, and therefore that system would be grossly unfair.
Right, I agreed on the unfair part. I just took a turn to questioning the oft-repeated claim that eating a reasonably healthy diet is really expensive compared to eating junk, and whether most poor people don't have access to supermarkets.
Quote:
Originally Posted by mathjak107
even salad stuff in nyc can be very very expensive . in fact salad stuff and fruit is our biggest expenses
This is interesting, how much would ingredients cost for a salad with iceberg lettuce, a bell pepper, a couple carrots, and some boiled eggs cost to prepare? In Phoenix AZ that is $5 and makes four servings.
Quote:
Originally Posted by mathjak107
anything we can think of gets thrown in a salad but i prefer shrimp or salmon . so this stuff ain't cheap .
One wealthy man's preference for shrimp and salmon in a high COLA area isn't exactly a useful data point for a discussion on whether poor people can't afford a reasonably healthy diet because it costs too much to eat healthy.
And it has an incredibly simple answer... because it can. Part of the answer is that doctors and hospitals are so burdened with rules, regulations, fees, paperwork, red tape, and bureaucracy and malpractice insurance that they must charge much higher prices to recoup those costs. But the main answer is, because we have come to believe that it's a good idea to divorce the consumer of this service (health care) from who pays, literally nobody cares about how much it is. The insurance companies don't care, they pay a fraction anyway, and can always charge higher premiums. The hospitals don't care because no matter if that bill ever gets paid, in part or in full, huge amounts of money are rolling in the door. And the patient doesn't care, because they expect and believe that they shouldn't have to pay for health care.
The best thing we could do to actually reform health care would be A) true malpractice reform, where malpractice is only found in the case where the provider was truly negligent and not just that there was an outcome someone was unhappy with; and B) ban health insurance other than catastrophic care policies. Yes, really... if we got back to everyone expected to pay their bills in full at the time of service, and not with "other people's money", we'd all start to care what those bills were, and providers could not charge prices that nobody could pay. Sixty years ago, this is what we had... you saw the doctor, you paid, and you didn't have to mortgage everything in your life for one night in the hospital.
But most people believe they have some kind of right to receive health care services without paying anything, so our system will continue to get worse and worse until it breaks. At least Europeans are willing to pay the massive tax burden for their "free" health care... we aren't.
"Most people" have a deduction from every paycheck for health insurance. I don't think "most people" believe they have a right to receive healthcare without paying anything. Most of us have faithfully paid insurance premiums for our entire working lives. I do think that most of us believe that a health condition/crisis should not drive families into bankruptcy.
Right, I agreed on the unfair part. I just took a turn to questioning the oft-repeated claim that eating a reasonably healthy diet is really expensive compared to eating junk, and whether most poor people don't have access to supermarkets.
This is interesting, how much would ingredients cost for a salad with iceberg lettuce, a bell pepper, a couple carrots, and some boiled eggs cost to prepare? In Phoenix AZ that is $5 and makes four servings.
One wealthy man's preference for shrimp and salmon in a high COLA area isn't exactly a useful data point for a discussion on whether poor people can't afford a reasonably healthy diet because it costs too much to eat healthy.
no one is talking about anyone else but ourselves . i found eating healthy considerably more in order to keep from going out of my mind with little variation. i mean we are talking 365 days of eating 3 meals a day . the standard cheap eats wears thin on me way to quickly .
sure , if you are poor and don't care what you eat or the variation you can swing it . but like anything , we don't need anything more then a tent and fishing pole to live . so it is only about "YOU ".
I often wonder about this. While I don't doubt it's true, I wonder how much access/cost is an issue versus choices.
Where I lived potatoes were cheap. Lettuce was cheap. Apples were cheap. Bananas were cheap. Combined with things like beans, rice, eggs, family pack chicken etc. is it really that expensive to eat healthy? Access I get that some poor people don't live very close to a supermarket so it isn't as convenient, but what percentage of them really can't manage a trip to the supermarket once per week?
Why should we expect the poor to eat healthy diets when the people with resources won't do it?
Why should we expect the poor to eat healthy diets when the people with resources won't do it?
There was a time when the poor often had to eat healthy by necessity...
At one time it was the norm to have vegetable gardens and plant fruit trees here in California... also, meat was reserved once a week for Sunday dinner... there was no such thing as Fast Food... even apartment dwellers had potted tomato plants or community gardens... unless it is marijuana the gardening bug is no where to be found so it seems.
Here is what I have seen managing low income property for 35 years...
Many are older single family homes in the SF Bay Area... bought and maintained with much pride many decades ago with vegetable gardens and fruit trees...
What is more typical today is getting calls to cut down and pick up rotten fruit... I kid you not.
One little home has an assortment of 50 year old trees... several apples, plum, peach, orange and lemon...
The resident has demanded I take them out... I mentioned the bounty of fruit there for the taking... she told me she doesn't like fruit unless it is perfect...
I wish this was just an isolated incident but unfortunately not...
One of the elderly neighbors told me she use to make apple pies from those apple trees... I asked if she would like some apples... she is 80 and her eyes lit up...
She picked up every apple and carted them home... at the table... each was inspected and pared...
Some of the best apple pie I ever had... sent one to my tenant who really enjoyed it... said there are more apples, plums and peaches... she could have a lot of fresh pies and the neighbor would be glad to show her how... no deal... she said she wasn't interested in picking fruit...
You can lead a horse to water but getting the horse to drink and another matter.
I think as Americans, we have less and less control over our time, and thus less opportunity to live a healthy lifestyle.
I was in the ER with a friend a couple days ago. Jam packed. Both the EMTs and the nurses commented how it happens every year at this time ....... stresses leading to bad behavior, leading to hospitals stays. Then throw in the fact that many medical professionals believe there is a physiological component to certain behaviors, and it would be hard to ration health care based on behavior.
The big problem is the social imperative to lead an unhealthy lifestyle. We were never meant to watch TV, ride around in vehicles and eat whenever we are hungry. A huge number of health problems arise directly from our sedentary lifestyle. The mobility limited people you see are in walkers and wheelchairs because they didn't use it, so they lost it. If you are only 2 miles from where you are going, walk there and back. To save time you will step right out and move along faster. You will live longer and be healthier if you do, and that means do it every day. Even a bare half hour a day will help.
It has been known for decades that the way to prevent chronic diseases is exercise, but sitting has reached epidemic status. If you keep a moderate, steady pace, you can walk 2 miles in about 45 minutes. There and back is an easy hour and a half workout that will do more for your health than all the food obsessions and puritan preaching in the world.
The big problem is the social imperative to lead an unhealthy lifestyle. We were never meant to watch TV, ride around in vehicles and eat whenever we are hungry. A huge number of health problems arise directly from our sedentary lifestyle. The mobility limited people you see are in walkers and wheelchairs because they didn't use it, so they lost it. If you are only 2 miles from where you are going, walk there and back. To save time you will step right out and move along faster. You will live longer and be healthier if you do, and that means do it every day. Even a bare half hour a day will help.
It has been known for decades that the way to prevent chronic diseases is exercise, but sitting has reached epidemic status. If you keep a moderate, steady pace, you can walk 2 miles in about 45 minutes. There and back is an easy hour and a half workout that will do more for your health than all the food obsessions and puritan preaching in the world.
I agree with you on exercise...swimming, yoga, walking....all so beneficial. That won't stop me from my preaching about the benefits of veganism, though.
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