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Nothing will work. We have organizations that represent medical factions, and that's it. And of course they are not coordinated and even at each others throats at times.
i.e. specialists get cut, primary gets raises, and ne'er the twain shall meet. Or something like that.
See I understand the business but, although I can hold my own, I never argue the practice of medicine with any practitioner. I don't even care the rates.
My philosophy in rate setting is give me true medical cost to care, pad overhead 10% because you never know, and be reasonable on profit margin, 5-10%.
So a 99201, 15 minute look see.
From the business side, reducing Doctor payments is not a cost savings
Like every time congress starts that whole bs with Medicare fee schedule.cost goes up but you guys are supposed to make due with rates set, say, 4 years ago? Bs political game
Says the person who is enjoying the internet and the computer, both inventions a result of government research and funding. Its also intersting that veterans heavily support the VA according to polls, and the seniors heavily support Medicare, social security and other programs that improve the lives of tens of millions of Americans.
The current health care system in America is by far the most expensive in the world, a whooping 18% of GDP, compared to the more cost effective 9-12% in other countries (America is the only country with a privatized system which doesnt guarantee health care to its people).
Well, since about 11% of that 18% is being paid by government simply propose a plan that will pay for single payer with existing dollars and you will have a poltically winning argument.
I'm waiting.
I think Obamacare was supposed to reduce our premiums. I won't get fooled again.
See I understand the business but, although I can hold my own, I never argue the practice of medicine with any practitioner. I don't even care the rates.
My philosophy in rate setting is give me true medical cost to care, pad overhead 10% because you never know, and be reasonable on profit margin, 5-10%.
So a 99201, 15 minute look see.
From the business side, reducing Doctor payments is not a cost savings
Like every time congress starts that whole bs with Medicare fee schedule.cost goes up but you guys are supposed to make due with rates set, say, 4 years ago? Bs political game
It finally stopped with the elimination of the SGR. But for decades the ploy was to threaten docs with a massive fee cut 'next year'. And then in the end give us a 0.something raise.
I chose that because true actuarlism will go much deeper. This is just a simple 'show cause'.
Using that as the baseline, utilization, and 'measuring the risk pool', basically it boils down to this:
To insure every American with universal care, under a single payer system, cost will be 1800 per person, per month, with current utilization. That means out of pocket. That means for a 4 year old or an 80 year old.
32000000 x 1800 = 57.6 billion per month
691 billion per year
I am NOT an advocate of taxpayer funded government provided, controlled, regulated or restricted health care in any shape or form.
If you want UNIVERSAL access to inexpensive and plentiful HEALTHCARE, you have to :
[] Expand access to medical training and education (triple the number of physicians, as well as other professionals)
[] Reduce the cost for acquiring training and education (more medical schools, apprenticeships, alternate ways to get credentials - perhaps by national examination)
[] Eliminate useless overhead expenses and regulations imposed by a mindless bureaucracy or a monopolistic trade association
[] Incorporate automation and mass production techniques where appropriate (can't be any worse than the current "office visit" where the patient is shuttled into a brief and perfunctory consultation and swiftly passed out the door).
None of these aspects are addressed by "Gov't / Single Payer" reform. And the current system of "licensed" practitioners has not eliminated physician error - as evidenced by the glut of malpractice claims - or the oft repeated tale of going from one doctor to the next (at our own expense), seeking an accurate diagnosis.
In short, "regulation" of medical care hasn't really helped the patient, as much as it enriched those who dispense it, and who control it. Giving more power to government will be a disaster.
In common sense terms, if you want "Universal Health Care", you cannot simultaneously restrict it, tax it, and burden it with bureaucracy - and expect success. I have no belief that credentials and licenses are assurances of competency and quality - otherwise why would anyone need a second opinion - or file a malpractice claim? And the institution of a government protected monopoly hasn't really benefitted the people, nor improved the quality of care, nor enabled more to receive needed care.
Would a free market be an improvement?
Open access to medical education for anyone?
Provide an incremental path for acquiring credentials, that are not career dead ends?
I am NOT an advocate of taxpayer funded government provided, controlled, regulated or restricted health care in any shape or form.
If you want UNIVERSAL access to inexpensive and plentiful HEALTHCARE, you have to :
[] Expand access to medical training and education (triple the number of physicians, as well as other professionals)
[] Reduce the cost for acquiring training and education (more medical schools, apprenticeships, alternate ways to get credentials - perhaps by national examination)
[] Eliminate useless overhead expenses and regulations imposed by a mindless bureaucracy or a monopolistic trade association
[] Incorporate automation and mass production techniques where appropriate (can't be any worse than the current "office visit" where the patient is shuttled into a brief and perfunctory consultation and swiftly passed out the door).
None of these aspects are addressed by "Gov't / Single Payer" reform. And the current system of "licensed" practitioners has not eliminated physician error - as evidenced by the glut of malpractice claims - or the oft repeated tale of going from one doctor to the next (at our own expense), seeking an accurate diagnosis.
In short, "regulation" of medical care hasn't really helped the patient, as much as it enriched those who dispense it, and who control it. Giving more power to government will be a disaster.
In common sense terms, if you want "Universal Health Care", you cannot simultaneously restrict it, tax it, and burden it with bureaucracy - and expect success. I have no belief that credentials and licenses are assurances of competency and quality - otherwise why would anyone need a second opinion - or file a malpractice claim? And the institution of a government protected monopoly hasn't really benefitted the people, nor improved the quality of care, nor enabled more to receive needed care.
Would a free market be an improvement?
Open access to medical education for anyone?
Provide an incremental path for acquiring credentials, that are not career dead ends?
Note: I started this thread for those who want it. I'm a consultant/problem solver who disagrees with it. However, my experience in the industry has touched every field. Seeing no blueprint from advocates, I took this upon myself. Without more access to info, which I couldn't nor shouldn't have, and using numbers from 2013 and extrapolating, that is the approximation based off American utilization.
I chose that because true actuarlism will go much deeper. This is just a simple 'show cause'.
Using that as the baseline, utilization, and 'measuring the risk pool', basically it boils down to this:
To insure every American with universal care, under a single payer system, cost will be 1800 per person, per month, with current utilization. That means out of pocket. That means for a 4 year old or an 80 year old.
32000000 x 1800 = 57.6 billion per month
691 billion per year
You are leaving out 2 very major things.
The first is most obvious and that is that the HC needs and costs of most individuals escalate dramatically as they age. Especially after the 5th decade.
The second is that a good portion of all these costs, present and future, will be made up with new money. Money that does not come from taxes, money that doesn't even exist today.
Also another 'minor' wrong conclusion. It is $6.9T not $690B!
I am NOT an advocate of taxpayer funded government provided, controlled, regulated or restricted health care in any shape or form.
If you want UNIVERSAL access to inexpensive and plentiful HEALTHCARE, you have to :
[] Expand access to medical training and education (triple the number of physicians, as well as other professionals)
[] Reduce the cost for acquiring training and education (more medical schools, apprenticeships, alternate ways to get credentials - perhaps by national examination)
[] Eliminate useless overhead expenses and regulations imposed by a mindless bureaucracy or a monopolistic trade association
[] Incorporate automation and mass production techniques where appropriate (can't be any worse than the current "office visit" where the patient is shuttled into a brief and perfunctory consultation and swiftly passed out the door).
None of these aspects are addressed by "Gov't / Single Payer" reform. And the current system of "licensed" practitioners has not eliminated physician error - as evidenced by the glut of malpractice claims - or the oft repeated tale of going from one doctor to the next (at our own expense), seeking an accurate diagnosis.
In short, "regulation" of medical care hasn't really helped the patient, as much as it enriched those who dispense it, and who control it. Giving more power to government will be a disaster.
In common sense terms, if you want "Universal Health Care", you cannot simultaneously restrict it, tax it, and burden it with bureaucracy - and expect success. I have no belief that credentials and licenses are assurances of competency and quality - otherwise why would anyone need a second opinion - or file a malpractice claim? And the institution of a government protected monopoly hasn't really benefitted the people, nor improved the quality of care, nor enabled more to receive needed care.
Would a free market be an improvement?
Open access to medical education for anyone?
Provide an incremental path for acquiring credentials, that are not career dead ends?
The basic problem with this approach is that it does not understand that medicine in general does not follow much in the way of free market principles. That being supply and demand. In too many cases and so many medical encounters, the typical supply and demand equation fails in medicine. For all sorts of reasons.
So the gist of that is that more docs means more HC spending. Not less due to competition.
Overheads are another topic. So much of overheads are necessary for patients safety.
Automation in medicine will not lower costs, they will increase them. The more patients I see in a day, the more testing and such that gets ordered. My salary is very meager compared to the total HC spending volume that I control as one doc.
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