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[quote=guidoLaMoto;50051706]Maybe you're not so old and you don't know medical care financing before Medicare: it IS the problem.
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Before WWII, having insurance was a rarity. How many old movies were there where Johnny needed an operation to walk again, but he couldn't afford it? Docs were paid in chickens & eggs. They didn't make the big bucks.
Before World War II, medicine couldn't do a lot for most people. It was cheap primarily because it had limited value.
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Then after WWII and growing power of unions, they pretty well pushed wages to the limit, so they started in on "benefits" like med insurance. With more demand due to "somebody else paying," prices started to rise.
I view this differently than you do. After World War II, innovation resulted in medicine becoming far more effective and saving and prolonging lives. For example, antibiotics were invented during the war and these wonder drugs saved tens of thousands of lives. As medicine became more effective, the demand for these services increased. Ordinary people sought health insurance because of the cost of care and its ability to heal.
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Then came Medicare, essentially pushing demand towards 100% (old people get sick, not young ones) and with full demand and still limited supply, prices continue to rise.
Medicare came about because private health insurers saw no profit in insuring the elderly who consumed the most medical care. Honest private insurers were actually part of a movement to get Congress to pass the original Medicare legislation in 1965.
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Those who want a single payor system forget that claims will still need to be processed. But instead of being processed by $12/hr starter level clerks, the claims will be processed by $30/hr govt union employees with obscenely lucrative benefits, who retire after only 25 yrs with nearly full wages.
Oh BS. Medicare processes far more claims than any other insurer in the country. Processing costs are lower than those of private insurance companies.
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We can't afford it. You socialists who keep pointing to the European system also forget that malpractice suits are rare in Europe.
No, we cannot afford to do what every other modern country has done for its citizens which is provide some system of universal health coverage. For some reason, America is different. It is incapable of doing what Canada did fifty years ago, what Britain did almost seventy years ago, and what France did decades ago. Even countries like Taiwan now have universal health care. Yet, in America we persist with this fairy tale that "we can't afford it".
And instead of responding to the information I provided that says medical malpractice accounts for only 2.4% of health care expenditures, you continue to bang the drum saying that its the cause of this whole problem. Your credibility is nonexistent at this point. You might actually want to try and come up with some evidence that supports your points.
You might actually want to try and come up with some evidence that supports your points
Case in point: You can buy an oxygen concentrator online for $500. Medicare reimburses medical supply company $5000 to supply it to patients. Similar mark-ups on other medical supplies, lab tests, meds, etc. Patients don't complain-- it's not out of their pockets. Suppliers don't complain-- who's going to turn down profits? There is no competition--govt decides prices, announcing what they will pay for goods and services up front.
Case in point: You can buy an oxygen concentrator online for $500. Medicare reimburses medical supply company $5000 to supply it to patients. Similar mark-ups on other medical supplies, lab tests, meds, etc. Patients don't complain-- it's not out of their pockets. Suppliers don't complain-- who's going to turn down profits? There is no competition--govt decides prices, announcing what they will pay for goods and services up front.
Well, you're being sort of selective with the truth here.
Before I turned 65 and had medicare, at about age 60, I needed an oxygen concentrator with my CPAP. I went through exactly what you describe with regular insurance...I think at the time it was BCBS. I had to pay a portion of it. When it stopped working I found it cheaper to buy one, rather than then go through Medicare.
The only problem with that is it would consume the entire current US Federal Budget.
Medicare costs 11K/person right now. Multiply by 330M (400M by 2050 if this insane immigration situation continues unabated) and you get numbers that exceed the entire outlays of the federal government.
So how would this be funded? How many people do YOU personally know that can afford to pay 11K/person for medical care for themselves and their family? I know two. Out of probably 500 people that I know roughly what their financial situation is.
The biggest problem with the health care system is that the government has banned the insurance products that MOST people need and want. Which is a policy that meets their needs, AND doesn't include coverage for things they do NOT require.
Government meddling made health insurance unaffordable by forcing insurers to cover routine health care instead of what insurance is SUPPOSED to be for - unforeseeable and random things.
Things that are legitimately in the domain of "health insurance" include:
-accidents (which does not include "I hurt myself skydiving or dirt biking or trying out that cool Jackass stunt". And not car accidents. Or workplace injuries.) Because all of those things are either your choice to take the risk or are the responsibility of other people and will be paid under a different policy.)
-Major illnesses - ie anything requiring hospitalization.
-Chronic illnesses.
-Cancers (unless due to the use of tobacco)
-Diagnostic imaging, laboratory, or physical tests related to the above.
-any medically necessary treatment the purpose of which is re-establish or improve the function of an organ or organ system.
Things that are NOT within the realm of "health insurance" include:
-routine "well visits", annual exams, checkups, etc.
-treatments delivered on an outpatient basis that do not require specialized equipment/tech or specialist training
-non-medical birth control or "reproductive services" not related directly to pregnancy or birth.
-vaccinations (recommended or not)
-treatments for addictions to anything that is not prescribed by a medical doctor
Why are these things not in the realm of insurance? Because you KNOW you are going to incur these expenses, that they are inevitable. Everyone knows that at some point you're going to get the "common cold". You don't need health insurance for these kinds of things, they happen to everyone, they are predictable and known, and they are not life threatening.
You simply do not need insurance for your sniffles. And you do not need antibiotics either. Get some rest and liquids, stay home from work/school, and you will be fine. Our ancestors didn't run off to the doctor every time they had a cold and yet here we all are.
What most people need, what covers the things I listed as being in the realm of actual insurance is "Major Medical". But the ACA banned these policies.
The only problem with that is it would consume the entire current US Federal Budget.
Medicare costs 11K/person right now. Multiply by 330M (400M by 2050 if this insane immigration situation continues unabated) and you get numbers that exceed the entire outlays of the federal government.
So how would this be funded? How many people do YOU personally know that can afford to pay 11K/person for medical care for themselves and their family? I know two. Out of probably 500 people that I know roughly what their financial situation is.
Universal health care--and yes. too much immigration presents a problem. The UK system worked great until they let in way too many people from their former commonwealth nations, people who never paid into the system. It doesn't work when people don't pay their share, of course. Too much immigration is also the reason for BREXIT--once they are out of European Union, they won't be flooded by immigrants who have not paid in.
Some immigration is fine, of course. As long as there are limits, the system can absorb some people who come and haven't paid in.
Well, you're being sort of selective with the truth here.
Before I turned 65 and had medicare, at about age 60, I needed an oxygen concentrator with my CPAP. I went through exactly what you describe with regular insurance...I think at the time it was BCBS. I had to pay a portion of it. When it stopped working I found it cheaper to buy one, rather than then go through Medicare.
I just looked up the details of what I posted here:
So, I'm on CPAP with supplemental oxygen at night due to sleep apnea (nothing during the day). Until I qualified for Medicare, my insurance paid $400 per month and I paid another roughly $20 per month for the oxygenator. So over 4 years, the company earned $19,200 on that rental...for the exact same machine I just bought new and under a 5 year warranty for $695. Oh, that profit of $18,425 profit did include a once a year visit to change the $20 filter.
Give Physician Assistants and RNs additional training in pharmacy and pharmacology and let them prescribe drugs. Why should I have to see a Doctor and have my BSBS billed $300 for a simple visit to get my prescriptions refilled?
My doctors office has one Dr and 2 nurse practitioners. The bill is the same regardless who you see.
The biggest problem with the health care system is that the government has banned the insurance products that MOST people need and want. Which is a policy that meets their needs, AND doesn't include coverage for things they do NOT require.
Government meddling made health insurance unaffordable by forcing insurers to cover routine health care instead of what insurance is SUPPOSED to be for - unforeseeable and random things.
Things that are legitimately in the domain of "health insurance" include:
-accidents (which does not include "I hurt myself skydiving or dirt biking or trying out that cool Jackass stunt". And not car accidents. Or workplace injuries.) Because all of those things are either your choice to take the risk or are the responsibility of other people and will be paid under a different policy.)
-Major illnesses - ie anything requiring hospitalization.
-Chronic illnesses.
-Cancers (unless due to the use of tobacco)
-Diagnostic imaging, laboratory, or physical tests related to the above.
-any medically necessary treatment the purpose of which is re-establish or improve the function of an organ or organ system.
Things that are NOT within the realm of "health insurance" include:
-routine "well visits", annual exams, checkups, etc.
-treatments delivered on an outpatient basis that do not require specialized equipment/tech or specialist training
-non-medical birth control or "reproductive services" not related directly to pregnancy or birth.
-vaccinations (recommended or not)
-treatments for addictions to anything that is not prescribed by a medical doctor
Why are these things not in the realm of insurance? Because you KNOW you are going to incur these expenses, that they are inevitable. Everyone knows that at some point you're going to get the "common cold". You don't need health insurance for these kinds of things, they happen to everyone, they are predictable and known, and they are not life threatening.
You simply do not need insurance for your sniffles. And you do not need antibiotics either. Get some rest and liquids, stay home from work/school, and you will be fine. Our ancestors didn't run off to the doctor every time they had a cold and yet here we all are.
What most people need, what covers the things I listed as being in the realm of actual insurance is "Major Medical". But the ACA banned these policies.
If you stop well visits, vaccinations and other preventative measures being covered, then the cancers an other serious illnesses are not going to be found until they are in later stages and much more expensive to treat. This applies to heart disease as well as many others. One of the reasons health insurance costs so much is because we in general are a sick country, with skyrocketing rates of Diabetes and heart disease. Rather than eliminating well visits, I think a better idea is incentivizing doctors like they do in UK. They get bonuses when their patient populations lose weight, quit smoking, etc.
In order to do this though the entire system has to be changed. You can't get results like that if you take 5 minutes with each patient because you have to rush to the next exam room. Doctors prescribe but they don't educate anymore, and it's actually not their fault but the way the system is set up.
Ending antibiotic use and heartburn meds and addiction treatment I think are the opposite of helpful. I think I see your point, that people drag their kids to the doc for every earache, but I don't think stopping treatments for illnesses until they are major illnesses is going to do anything but increase health care costs in the long run.
I agree with you about the jury system and malpractice suits.
I once got a diagnosis for kidney cancer. Misdiagnosis. Of course, not having cancer was a blessing, but still, that was malpractic.
Recently I got a diagnosis of thrush in the mouth and throat. Put on a succession of medicines, the last of which was potentially very dangerous (sudden death, congestive heart failure, temporary or permanent deafness). Again...fortunately for me...another misdiagnosis. Telephone calls from the doctor's office with results of my tests...twice...only problem those 2 times was that I hadn't had any tests. Ill-advised meds a couple of times due to my heart condition. None of these involved serious illness as a result of the misdiagnosis, but still...doctor's feet need to be held to the fire.
I don't quite agree, however, with your contention that the primary cause of how expensive health care is, is the result of high pay in the field. First, I think it has to be high due to the expense of long years in medical school. I think the greater problem is the high cost of modern medical equipment. The most modern MRI machine now costs about $3 million!
I think your "public utility" approach shows promise.
I think it's just greed. I had outpatient back surgery last year at a local hospital. I was in at 6am and home around noon. The hospital bill for use of the room (not including the surgeon or anesthesiologist which were billed separately) was $64,000. Of course insurance doesn't pay that much, but if I hadn't had insurance that would have been my bill...WHY? Why does the nursing home I work in charge $10,000 a month or so? It is certainly not due to anyone's high pay, the majority of workers are in the $10/hour range, with only a few therapists and nurses and administrators who make higher salaries.
As long as health care is allowed to be corporate and privatized, and corporate people get to set whatever prices they want (like that asshat who bought the rights to EpiPen and raised it from a couple of hundred to several thousand, just because he could) costs are not going to be controllable, because politicians are loath to interfere with private business.
That to me is the biggest difference between health care now and 20 years ago. Hospitals and medical facilities used to be non-profit, or low profit. Now they are all part of giant conglomerates and like other giant conglomerates, are beholden first and foremost to their stockholders. Hospital heads who used to make $100,000 a year now can make ginormous bonuses for increasing profits, and that is never going to benefit the public because the only way to increase profits is to cut services or raise prices.
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