A large wealth gap (due to capitalism) will not end well for the country - my personal take (unemployment, employees)
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Sure. All 5,238 currently operating hospitals in the US.
Some of them are organized as monopoly cartels like TriHealth, MercyHealth etc etc etc. I believe in California there's one called Kaiser or Kaiser Permanente.
You see the universal healthcare systems in the Euro-States, but you don't understand them, and so you don't understand how it is possible for them to achieve the cost-savings they do, which is what allows them to have universal healthcare systems in the first place.
The Euro-States can do what they do because they abandoned the Hospital Model and they don't have monopolies.
If you don't believe that, then read what the former German Minister of Health said:
Polyclinics—clusters of general practitioners who work together to form more specialized primary care centers—were used extensively and quite successfully in the former German Democratic Republic.
However, many politicians in West Germany initially disliked the idea of polyclinics because they associated them with communist ideology. It took a while for many people to understand that polyclinics offer significant advantages with regard to communication, coordination, and cooperation.
Source: How Germany is reining in health care costs: An interview with Franz Knieps pp 30-31.
Do you understand the words coming out of his mouth?
It's deliciously ironic.
The "commie" States (which were actually Socialist) adopted one of the corollaries of Capitalist Property Theory, namely, Diversification & Specialization.
They had no choice. The US and Britain barred East Bloc currencies from being traded on the world market which left those economies in constant turmoil for 48 years.
The only way they could provide healthcare is by significantly reducing the cost of healthcare delivery.
When The Wall came down, the Western Euro-States said, "Wow! We're on it!" So, they abandoned the Hospital Model in favor of the Clinic Model and/or Polyclinic Model.
If you want a universal system that doesn't bankrupt the US, then you must do what they did and get rid of hospitals.
The Hospital Model is the most costly, most inefficient, most ineffective means of healthcare delivery and it is championed by the American Hospital Association who not only wrote the Medicare legislation, they also wrote Obamacare.
Yes, old habits die hard, and there are medical facilities in Euro-States that are still called hospitals, but they are absolutely nothing like hospitals as you understand them.
These are the services a typical US hospital provides: Allergy, Anesthesia, Bariatric Medicine/Surgery, Burn/Trauma, Cardiac Catheterization, Cardiology, Cardiovascular Surgery, Colorectal Surgery, Dermatology, Electrophysiology, Emergency Medicine, Endocrinology, Family Practice, Geriatrics, Gynecologic Oncology, Hematology/Oncology, Hepatobiliary, Infectious Disease, Internal Medicine, Interventional Radiology, Neonatology, Nephrology, Neuroradiology, Neurology, Neurosurgery, Nuclear Medicine, Obstetrics & Gynecology, Occupational Medicine, Ophthalmology, Otolaryngology/Head & Neck Surgery, Palliative Care, Pathology, Pediatrics, Pediatric Surgery, Plastic & Reconstructive Surgery, Podiatric Surgery, Psychiatry, Pulmonary Medicine, Radiation Oncology, Radiology, Rheumatology, Surgical Oncology, Thoracic Surgery, Transplant Surgery, Wound Care, ENT, General Surgery, Gastroenterology, Oral/Dental Surgery, Orthopedic Surgery, Pain Management, Urology and Vascular Surgery.
There are no hospitals in Europe like that.
Even in the rural areas of France and Germany -- and there are rural areas as you know and understand them -- there are hospitals, but they have only a Level I trauma center and basic services.
Nothing specialized.
A rural hospital would look like Anesthesia, Emergency Medicine, Family Practice, Geriatrics, Internal Medicine, Radiology, Neonatology, Obstetrics & Gynecology, Occupational Medicine, Ophthalmology, Palliative Care, Pathology, Pediatrics, Wound Care, ENT, General Surgery, and Oral/Dental Surgery.
The problem with the Hospital Model combined with monopoly is redundancy.
The Cincinnati MSA is 11 counties with 3 Million people and 17 hospitals of which 2 are spinal/TBI/stroke rehab. The other 15 all offer open-hearty surgery.
Berlin is a city-State that has 8 Million people and only 3 cardio-pulmonary centers providing open-heart surgery.
See the difference?
It costs less in Berlin than in Cincinnati.
Technology is the biggest drive of healthcare costs because there is no economy of scale.
TVs cost $300 because you have economy of scale since you're manufacturing for 128 Million households and on top of that most households want more than one TV.
You're manufacturing MRIs for 5,000 hospitals. Where's the economy of scale? It's in a box over yon.
If you manufactured MRIs for 128 Million households --many of which wanted more than one MRI -- then, yeah, MRIs would cost $750 instead of $500,000 to $1.3 Million.
So Germany and France, in addition to eliminating hospitals, and eliminating monopolies have taken the additional step of limiting specialized services to save money.
For example, as an Army or Air Force member, if your spouse or child had a heart condition, there's only one place you could be stationed and that is in the Kaiserslautern Military Community.
Why? Because there's a cardio-pulmonary clinic and Landstuhl Army Regional Medical Center which also had a very fine cardio-pulmonary clinic so your spouse or child would never be more than 10-12 minutes away from the critical care they need.
If you were based in Bremerhaven or Garlstedt, your spouse or child might die, because the nearest cardio-pulmonary clinic is 4 hours away in Hamburg. If you were German and lived in Hanover, you probably wouldn't drive to Hamburg, instead you'd go to Münster since it's only about 3.5 hours away.
Europeans are willing to drive farther to get specialized medical care in order to avoid duplication/redundancy and reduce the cost of medical care.
Are Americans willing to do the same?
Because if you're not willing to eliminate monopolies and get rid of hospitals and limit specialized medical care, then you will never enjoy the cost-savings that Euro-State have.
If you're not willing to do that, you won't save a penny and you'll actually increase costs by 10%-20%.
Had you bothered to do any research on the subject -- and obviously you haven't -- then you'd have gone to the EuroStat database and searched to see that 4%-8% of Europeans complain that they didn't get healthcare because it's too far to travel.
If you want fix your healthcare system, then Congress needs only to:
1) withhold Medicaid funding from States who refuse to repeal the "enabling laws."
2) withhold Medicaid funding from States who refuse to pursue anti-trust action against hospital monopolies (after repealing the "enabling laws")
3) withhold Medicaid funding from States that don't levy penalizing licensing fees for hospital services
4) withhold Medicaid funding from States who refuse to abandon their Soviet-style Command Economic System and repeal insurance regulations to allow Americans to buy the insurance they want and not what the States dictate they buy
5) repeal that section of the 1954 IRS Tax Code incorporated into the 1986 IRS Tax Code to allow Americans to create generational wealth and pass it on
The first two will reduce medical costs 40%-60% almost over-night and in turn reduce health plan costs by 40%-60%.
The third will reduce medical costs another 10%-30% and drive down health plan costs another 10%-30%.
The fourth will allow everyone to purchase at least some level of affordable health plan coverage.
The last will allow Americans to once again profit off of their health plan coverage.
Oh, wait...what am I saying? You're probably one of those people who thinks profits are bad.
Maybe they should ease up on the overregulation then?
Every time I go to see a doctor, there are more backoffice staff than there are doctors by a factor of 3. That is NOT a sustainable business model in any professional services practice.
That ratio should be reversed (3 doctors for every 1 backoffice person).
That’s not because of over-regulation, it’s because of onerous insurance requirements, denials, etc from many different insurance companies.
In an irony this is an American phenomenon. I was amazed when I used the health system in the UK how this is not the case there. More administratively efficient. They also make greater use of lower order gradations like nurse practitioners for your basic visits.
Sometimes I think the reason we can't have a decent health care system in the U.S. has to do with our culture.
That’s because they don’t have to deal with insurance companies, so they don’t have the huge administrative burden.
If you go to a cosmetic surgeons office you won’t see the same large staff, because they deal with self-pay not insurance. My hormone doctor had one person in his office, because he didn’t take insurance.
Sure. All 5,238 currently operating hospitals in the US.
Some of them are organized as monopoly cartels like TriHealth, MercyHealth etc etc etc. I believe in California there's one called Kaiser or Kaiser Permanente.
You see the universal healthcare systems in the Euro-States, but you don't understand them, and so you don't understand how it is possible for them to achieve the cost-savings they do, which is what allows them to have universal healthcare systems in the first place.
The Euro-States can do what they do because they abandoned the Hospital Model and they don't have monopolies.
If you don't believe that, then read what the former German Minister of Health said:
Polyclinics—clusters of general practitioners who work together to form more specialized primary care centers—were used extensively and quite successfully in the former German Democratic Republic.
However, many politicians in West Germany initially disliked the idea of polyclinics because they associated them with communist ideology. It took a while for many people to understand that polyclinics offer significant advantages with regard to communication, coordination, and cooperation.
Source: How Germany is reining in health care costs: An interview with Franz Knieps pp 30-31.
Do you understand the words coming out of his mouth?
It's deliciously ironic.
The "commie" States (which were actually Socialist) adopted one of the corollaries of Capitalist Property Theory, namely, Diversification & Specialization.
They had no choice. The US and Britain barred East Bloc currencies from being traded on the world market which left those economies in constant turmoil for 48 years.
The only way they could provide healthcare is by significantly reducing the cost of healthcare delivery.
When The Wall came down, the Western Euro-States said, "Wow! We're on it!" So, they abandoned the Hospital Model in favor of the Clinic Model and/or Polyclinic Model.
If you want a universal system that doesn't bankrupt the US, then you must do what they did and get rid of hospitals.
The Hospital Model is the most costly, most inefficient, most ineffective means of healthcare delivery and it is championed by the American Hospital Association who not only wrote the Medicare legislation, they also wrote Obamacare.
Yes, old habits die hard, and there are medical facilities in Euro-States that are still called hospitals, but they are absolutely nothing like hospitals as you understand them.
These are the services a typical US hospital provides: Allergy, Anesthesia, Bariatric Medicine/Surgery, Burn/Trauma, Cardiac Catheterization, Cardiology, Cardiovascular Surgery, Colorectal Surgery, Dermatology, Electrophysiology, Emergency Medicine, Endocrinology, Family Practice, Geriatrics, Gynecologic Oncology, Hematology/Oncology, Hepatobiliary, Infectious Disease, Internal Medicine, Interventional Radiology, Neonatology, Nephrology, Neuroradiology, Neurology, Neurosurgery, Nuclear Medicine, Obstetrics & Gynecology, Occupational Medicine, Ophthalmology, Otolaryngology/Head & Neck Surgery, Palliative Care, Pathology, Pediatrics, Pediatric Surgery, Plastic & Reconstructive Surgery, Podiatric Surgery, Psychiatry, Pulmonary Medicine, Radiation Oncology, Radiology, Rheumatology, Surgical Oncology, Thoracic Surgery, Transplant Surgery, Wound Care, ENT, General Surgery, Gastroenterology, Oral/Dental Surgery, Orthopedic Surgery, Pain Management, Urology and Vascular Surgery.
There are no hospitals in Europe like that.
Even in the rural areas of France and Germany -- and there are rural areas as you know and understand them -- there are hospitals, but they have only a Level I trauma center and basic services.
Nothing specialized.
A rural hospital would look like Anesthesia, Emergency Medicine, Family Practice, Geriatrics, Internal Medicine, Radiology, Neonatology, Obstetrics & Gynecology, Occupational Medicine, Ophthalmology, Palliative Care, Pathology, Pediatrics, Wound Care, ENT, General Surgery, and Oral/Dental Surgery.
The problem with the Hospital Model combined with monopoly is redundancy.
The Cincinnati MSA is 11 counties with 3 Million people and 17 hospitals of which 2 are spinal/TBI/stroke rehab. The other 15 all offer open-hearty surgery.
Berlin is a city-State that has 8 Million people and only 3 cardio-pulmonary centers providing open-heart surgery.
See the difference?
It costs less in Berlin than in Cincinnati.
Technology is the biggest drive of healthcare costs because there is no economy of scale.
TVs cost $300 because you have economy of scale since you're manufacturing for 128 Million households and on top of that most households want more than one TV.
You're manufacturing MRIs for 5,000 hospitals. Where's the economy of scale? It's in a box over yon.
If you manufactured MRIs for 128 Million households --many of which wanted more than one MRI -- then, yeah, MRIs would cost $750 instead of $500,000 to $1.3 Million.
So Germany and France, in addition to eliminating hospitals, and eliminating monopolies have taken the additional step of limiting specialized services to save money.
For example, as an Army or Air Force member, if your spouse or child had a heart condition, there's only one place you could be stationed and that is in the Kaiserslautern Military Community.
Why? Because there's a cardio-pulmonary clinic and Landstuhl Army Regional Medical Center which also had a very fine cardio-pulmonary clinic so your spouse or child would never be more than 10-12 minutes away from the critical care they need.
If you were based in Bremerhaven or Garlstedt, your spouse or child might die, because the nearest cardio-pulmonary clinic is 4 hours away in Hamburg. If you were German and lived in Hanover, you probably wouldn't drive to Hamburg, instead you'd go to Münster since it's only about 3.5 hours away.
Europeans are willing to drive farther to get specialized medical care in order to avoid duplication/redundancy and reduce the cost of medical care.
Are Americans willing to do the same?
Because if you're not willing to eliminate monopolies and get rid of hospitals and limit specialized medical care, then you will never enjoy the cost-savings that Euro-State have.
If you're not willing to do that, you won't save a penny and you'll actually increase costs by 10%-20%.
Had you bothered to do any research on the subject -- and obviously you haven't -- then you'd have gone to the EuroStat database and searched to see that 4%-8% of Europeans complain that they didn't get healthcare because it's too far to travel.
If you want fix your healthcare system, then Congress needs only to:
1) withhold Medicaid funding from States who refuse to repeal the "enabling laws."
2) withhold Medicaid funding from States who refuse to pursue anti-trust action against hospital monopolies (after repealing the "enabling laws")
3) withhold Medicaid funding from States that don't levy penalizing licensing fees for hospital services
4) withhold Medicaid funding from States who refuse to abandon their Soviet-style Command Economic System and repeal insurance regulations to allow Americans to buy the insurance they want and not what the States dictate they buy
5) repeal that section of the 1954 IRS Tax Code incorporated into the 1986 IRS Tax Code to allow Americans to create generational wealth and pass it on
The first two will reduce medical costs 40%-60% almost over-night and in turn reduce health plan costs by 40%-60%.
The third will reduce medical costs another 10%-30% and drive down health plan costs another 10%-30%.
The fourth will allow everyone to purchase at least some level of affordable health plan coverage.
The last will allow Americans to once again profit off of their health plan coverage.
Oh, wait...what am I saying? You're probably one of those people who thinks profits are bad.
Dude...you should simply stop posting about economics. Loud, long and usually wrong is a losing combination.
A monopoly is a single company that dominates an industry to the point it faces no pricing pressure, limits output, severely curtails R&D and capital expansion efforts etc. etc.
In an irony this is an American phenomenon. I was amazed when I used the health system in the UK how this is not the case there. More administratively efficient. They also make greater use of lower order gradations like nurse practitioners for your basic visits.
Sometimes I think the reason we can't have a decent health care system in the U.S. has to do with our culture.
That’s because they don’t have to deal with insurance companies, so they don’t have the huge administrative burden.
Then it would be worse, because I'd be uninsured, paying outraegeos rates with no protection. I can never get a straight answer on what anything costs. I've called a dozen providers before asking about the same thing. None of them could answer what it costs.
It was you that proposed going all cash - your exact words were "Also how many times do I have to say I would rather have an all-cash pay as you go system than the corruption we have" - my point was that you are free to do so at any point.
You also were complaining about $225K wasted, you either pay for insurance or go without - my point is insurance is your choice. I am sure all providers can give the price if uninsured - they all have a "rack" rate but costs can go up as situation changes during a procedure.
So your idea is to replace insurance companies with another insurance company (Medicare)? A Government one?
Note, Government has only ONE core competency - imposing administrative burdens. Wait, they have another one - wasting truckloads of taxpayers' money.
Hard Pass on paying half my salary towards Medicare.
Medicare works well. Centralized card works well in other countries. It is those administrative costs plus lawyers, that make our health care so expensive (plus plain greed in some cases too).
Medicare works well. Centralized card works well in other countries. It is those administrative costs plus lawyers, that make our health care so expensive (plus plain greed in some cases too).
People on the left always manage forget the part about Medicare cost shifting all sort of burdens onto providers.......vast underpayments, administrative burdens etc.
And of course these ideas would force millions of well paid Americans out of work.
People on the left always manage forget the part about Medicare cost shifting all sort of burdens onto providers.......vast underpayments, administrative burdens etc.
And of course these ideas would force millions of well paid Americans out of work.
What jobs, in insurance companies? Administrate positions? Both will result in lower health care costs. I have worked in health care for 25 years, Medicare doesn’t have even a fracture of administrative burdens as private insurance does.
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