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Old 11-29-2012, 06:59 PM
 
31,385 posts, read 32,103,545 times
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Quote:
Originally Posted by RebelYell14 View Post
Free Market allows much more competition which drives prices down.
The "free market" works just fine for elective procedures. You can go all over the place getting the best price for a face lift but it simply doesn't work for illness. I know I tried. As an experiment during two hospitalizations I tried to apply market principles.

Case 1, I passed out as the result of a systemic bacterial infection. My wife called 911 and the city's fire department responded as expected. Now I suppose that my wife could have tried to find a phone book and start calling private ambulance services to get the best price and talking to them about the quality of their care, but common sense sort of overode that idea. (One of the great benefits of the city's service was I was treated by an EMT and para-medic and an Air Force Para Rescue medic doing an internship).

I was asked which hospital ER that I wanted to be transported, in a free market I would have been abled to call a head and determine the best price, but best price for what? "Excuse me, what do you charge for admittance to your emergency room for an undiagnosed illness?"

Upon arrival at the hospital I didn't get to choose my doctor, make an informed decision about the test that were ordered or inquire about the price. I was running a 104 temp and was barely conscious.

As for insurance, funny thing, my insurance covered my hospital BUT not the infectious disease doctors who were sent in to review my case!

I could go on and on about how and where the "market" fails in the delivery of most healthcare. In fact we were thinking about producing a semi-humorous film about the experiment (we still might). But the point remains, healthcare for the most part doesn't allow comparative shopping, informed choice, or other principles of market economics.
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Old 11-29-2012, 07:07 PM
Status: "Summer!" (set 21 days ago)
 
Location: Foot of the Rockies
87,011 posts, read 102,621,396 times
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Quote:
Originally Posted by Robin Rossi View Post
Actually, it already does. Witness how relatively inexpensive elective care is like vision corrective laser surgery.


Ooops, that pesky real-world kicks in.
Oh, aren't you the clever one! You do realize, don't you, that vision correction laser surgery is fairly simple, in/out in a couple of hours, if that, few complications, etc.

LASIK eye surgery: Results - MayoClinic.com

Cancer treatment, chronic disease management, and the like are much more complicated, require repeated visits, etc. There's much more variation in the treatment. There's a reason oncologists aren't competing for price.
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Old 11-29-2012, 07:16 PM
 
40 posts, read 35,360 times
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Am I the only one seeing this as irrelevant? There has never been a system like free market health care. This reads like a cause problem then sell a solution type of scam to me.
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Old 11-29-2012, 07:37 PM
 
113 posts, read 86,425 times
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Quote:
Originally Posted by Grim Reader View Post
Repeating it doesn't make it true. First off, private debt tends to be associated with housing and consumption, not health care. Given that studies show how little is used on private health care in other nations, I don't see how it could possibly be on a scale to impact debt levels. Honestly, you'd have to have lived in the US all your life to see that as a possiblity! Elsewhere, the notion that healthcare might eat up that much money just wouldn't occur.

Here:

Source: Wall Street Journal

The pink bar is private spending. The red one is public -from taxes. Note how little other countries spend on supplemental health care? (The Canadian figures are inflated due to Americans purcasing drugs in Canada. Registered as private spending)
This graph is great for showing how stupid it is to say that America has a free market system. It has more PUBLIC spending alone than other countries with universal healthcare. Why is that? A couple come to mind: stricter patent laws and stricter licensing laws. US Doctors have to go to postsecondary education for a longer period of time. There are huge waiting lists for going to college to be a nurse, at least where I am from, because you have to get government specified certification. These licensing laws prevent a huge influx of labor which would drive down salaries drastically. Another thing that drove up costs were HMO's, which came into existence under Nixon. Insurance on a real free market would be high deductible, not pay for everyday care, and be drastically cheaper. The reason it is not high deductible and low cost is because of government mandates on what insurance companies have to pay for. Those with insurance (government controlled) or outright government care right now do not generally know and/or care what the hospitals are charging, and that's what drives the costs way up. Return that completely to the market, with people paying out of pocket, and the prices would be driven down drastically. The lack of paperwork alone would save an enormous amount of money.

In this country, young people pay a whole lot for old people's medical care, even though the old paid very little in their lifetimes, and in fact none at the beginning for some. The Medicare tax started in 1966 at .7% (total, counting employer portion which should count). It is now 2.9%. As a comparison, SS was at 5.8% in 1966, and is now 10.4% (down from 12.4% due to the temporary cut). Social Security is underfunded, but Medicare is a complete joke. Medicare cost 523 billion this year, compared to SS's 823 billion. People who say they paid into Medicare and have a right to it are full of it. They paid a drop in the bucket, and young people are screwed by having to pay for old people's care. And what's worse is it's racist, and sexist. Women live longer, and white people live longer, so minorities and men have to pay for old white women's medical care?

There are varying rates of inflation in this country, and those rates of inflation are directly related to how much the government is involved in the industry. The government is probably most involved in health care and education, and those prices are rising at the fastest rates. The government is increasingly getting involved in food stamps, and food prices are inflating at a growing rate. Price deflation occurs only in the industries in which the government is not heavily involved. How people can't see that is beyond me.
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Old 11-29-2012, 07:40 PM
 
31,385 posts, read 32,103,545 times
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Quote:
Originally Posted by Katiana View Post
Cancer treatment, chronic disease management, and the like are much more complicated, require repeated visits, etc. There's much more variation in the treatment. There's a reason oncologists aren't competing for price.
An interesting article on the behind the scenes machinations of hospitals, insurance companies and physicians. Not very free market.

Tips for doctors who negotiate reimbursement rates with insurance companies
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Old 11-29-2012, 07:58 PM
 
31,385 posts, read 32,103,545 times
Reputation: 14896
Quote:
Originally Posted by majinkoola View Post
This graph is great for showing how stupid it is to say that America has a free market system. It has more PUBLIC spending alone than other countries with universal healthcare. Why is that? A couple come to mind: stricter patent laws and stricter licensing laws. US Doctors have to go to postsecondary education for a longer period of time. There are huge waiting lists for going to college to be a nurse, at least where I am from, because you have to get government specified certification. These licensing laws prevent a huge influx of labor which would drive down salaries drastically.
You've got to be kidding! Yes, all across the EU you go to high school maybe college and then go out and hang a shingle calling yourself a doctor... puleeeze. In Great Britain one starts with a five year undergraduate medical education, followed by a 2 year foundation programme which is then followed by years of specialty training just like... guess what... the U.S.

http://www.nhscareers.nhs.uk/explore...l-education/hm

Quote:
Another thing that drove up costs were HMO's, which came into existence under Nixon.
You mean when HMO's converted from non-profit to profit status!

Quote:
Insurance on a real free market would be high deductible, not pay for everyday care,
That makes utterly no sense. In a free market if an insurance company could make more money by offering a lower deductible than its competitors it would offer a lower deductible than its competitors. That being the case many of those competitors would lower then have to lower the cost theirs deductibles as well due to... drum roll...MARKET FORCES!

I get oh so tired of people posting make believe and spouting about concepts that they have no clue about.
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Old 11-29-2012, 10:02 PM
 
113 posts, read 86,425 times
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Quote:
Originally Posted by ovcatto View Post
You've got to be kidding! Yes, all across the EU you go to high school maybe college and then go out and hang a shingle calling yourself a doctor... puleeeze. In Great Britain one starts with a five year undergraduate medical education, followed by a 2 year foundation programme which is then followed by years of specialty training just like... guess what... the U.S.

http://www.nhscareers.nhs.uk/explore...l-education/hm



You mean when HMO's converted from non-profit to profit status!



That makes utterly no sense. In a free market if an insurance company could make more money by offering a lower deductible than its competitors it would offer a lower deductible than its competitors. That being the case many of those competitors would lower then have to lower the cost theirs deductibles as well due to... drum roll...MARKET FORCES!

I get oh so tired of people posting make believe and spouting about concepts that they have no clue about.
4 years of college + 4 years of medical school + internship + residency is greater than what it takes in the UK. Way to exaggerate what I said.

Nixon required than employers offer federally controlled HMO's. HMO's that were lower deductibles and covered more things than what was previously offered. Prior to gov't involvement, there were much more high deductible, low premium plans. Why? Because of what you said, market forces. Companies couldn't make more money by offering a lower deductible because they had to have higher premiums. And out of pocket health care costs were so much drastically lower then because so many more people paid out of pocket, so that's why people chose the higher deductible, lower premium plans.


I majored in econ at a top 10 university. I get tired of people who don't understand economics, but even more tired of people who can't use grammar correctly - "That being the case many of those competitors would lower then have to lower the cost theirs deductibles"
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Old 11-30-2012, 02:38 AM
 
1,736 posts, read 1,592,292 times
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Quote:
Originally Posted by Mircea View Post
I will let the German Minister of Heath refute and debunk you....

In the past 20 years, our over-riding philosophy has been that the health system cannot spend more than its income." --- Franz Kneips, German Ministry of Health - 2009

Single-payer costs less, because governments spend less.

It's a real simple concept.
Glad some one said it. Yes it is. Real simple. They spend less, they get as good results. Or better.

That is the definition of "cheaper".

It also fits the definition of "more efficient".

Quote:
Originally Posted by Mircea View Post
I can create a single-payer system in the US, limit spending to $2,500 per person per year, and then strut about like a friggin' pompous ass proclaiming that the US has the cheapest health care system in the world.

But then a lot of Americans would die, because they would not get the health care they need.
Actually, you'd then be spedning roughly as much as the UK did in 2003. Or Japan in 2005, or Sweden in 2002, or New Zealand in 2006. How do you think their results from those years compare with the US results form spending $ 8000 in 2011?

They do better. Lots of people didn't die. America is bottom of the table of under-75s dying who wouldn't have if they got apropriate healthcare. Amendable mortailty.

I mean, I don't think you get the scale of the US problem. You've picked a number that you think is vastly below minimum here, and it turns out lots of nations got better results with it in the last 10 years!

Quote:
Originally Posted by Mircea View Post
Yes, countries with UHC/single-payer plans ration health care. They deny treatment. They delay treatment. They dilute treatment to the point of being ineffective.

I don't suppose it ever occurred to you that health costs a lot in the US, because it really does cost that much to properly treat people......without denying them care, without delaying their care and without diluting their treatment..
No, it really doesn't. I mean every other country pays much less, and most of them get better results. The average first world nation pays half of what the US does. And they live longer and in better health. Including the ones with more mixed populations and poor diets. Thats pretty damning evidence.

Quote:
Originally Posted by Mircea View Post
Going back to the German Minister of Heath...

In the past 20 years, our over-riding philosophy has been that the health system cannot spend more than its income." --- Franz Kneips, German Ministry of Health - 2009

....if the government is not spending more than it collects in revenues, then it should be more than obvious that people are not getting the best medical treatment.
You know, if your assumption is that "the government has to spend more than it takes in", no wonder things get out of control. It is possible to match your income to your spending. Or better. Look at Germany. Costs are 2/3rds of the US, results are better, and their system runs a 30 billion surplus this year.

Quote:
Originally Posted by Mircea View Post
Uh, healthcare service providers collude and charge higher fees...

In may areas of the US, you have competing monopolistic cartels. Here we have Tri-Health as one OPEC-style cartel, and then the Health Alliance is the other OPEC-style cartel.

And even though they are supposed to be competing against each other, they collude to fix prices at higher levels. They even black-list and low-ball hospitals that refuse to join the cartels, in order to force them to join.
Yes, we've been over that. Price elasticity and barriers to entry. The customer cannot refuse the commodity if prices are too high, and it is hard for new providers to enter the market. So competing on price becomes unprofitable, since you don't lose costomers for high ones.

The average first world country spends half what the US does on healthcare. In dollars per citizen or percentage of GDP. The average first world country gets better results.

They got all the same expenses, technologies, nurses etc. At some point, Americas got to get with the program.
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Old 11-30-2012, 02:49 AM
 
1,736 posts, read 1,592,292 times
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Quote:
Originally Posted by majinkoola View Post
This graph is great for showing how stupid it is to say that America has a free market system. It has more PUBLIC spending alone than other countries with universal healthcare. Why is that?
Fragmentation and a bloated gatekeeper function are biggies. The US runs a lot of systems in paralell for government health care, with a lot of duplication of effort. Medicare, Medicaid, VHA, IA, Childrens etc. Most nations can run a UHC for slightly less than those systems cost per person.



And for a second opinion:



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Old 11-30-2012, 07:09 AM
 
Location: somewhere in the woods
16,884 posts, read 13,039,376 times
Reputation: 5212
Quote:
Originally Posted by Grim Reader View Post
Fragmentation and a bloated gatekeeper function are biggies. The US runs a lot of systems in paralell for government health care, with a lot of duplication of effort. Medicare, Medicaid, VHA, IA, Childrens etc. Most nations can run a UHC for slightly less than those systems cost per person.



And for a second opinion:



great.

now take out the amount of money that each of those goverments tax people on for UHC and see how much it costs people then. i prefer to be able to make my own medical choice and not have goverment choose it for me.
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