[LasVegasPlayer]

Originally Posted by NYtoVT

All the above discussion is all well and good but fails to answer why a routine hernia operation on a healthy 35 yer-old male costs upwards of $50k. The whole thing makes no sense at all.

Hospitals should have to charge cash customers the same as the insurance discount. What happens is that they hospitals have to over bill the insurance company so that when they get the x% it is what they actually needed for the procedure. That was another issue with ACA as it didn't address that either.

[ScoopLV]

Originally Posted by NYtoVT

All the above discussion is all well and good but fails to answer why a routine hernia operation on a healthy 35 yer-old male costs upwards of $50k. The whole thing makes no sense at all.

Answer: malpractice insurance, medical school tuition, health insurance for everyone from the doctor who performed the surgery down to the receptionist who handled the paperwork, profit for the insurance companies and dividends for their shareholders, the cost of medical supplies (and the complete gouging of the patient for such supplies -- $500 for a bag of saline, for instance), salaries for everyone involved with the hospital, commission for the pharmaceutical reps who sell the drugs.

Get that same operation in Mexico and it's a few thousand instead. Why do you think medical tourism is a thing?

[NYtoVT]

Originally Posted by ScoopLV

Answer: malpractice insurance, medical school tuition, health insurance for everyone from the doctor who performed the surgery down to the receptionist who handled the paperwork, profit for the insurance companies and dividends for their shareholders, the cost of medical supplies (and the complete gouging of the patient for such supplies -- $500 for a bag of saline, for instance), salaries for everyone involved with the hospital, commission for the pharmaceutical reps who sell the drugs.

Get that same operation in Mexico and it's a few thousand instead. Why do you think medical tourism is a thing?

Agree. So what's the answer ? I don't have one other than the simplistic wage and price controls. Tort reform would take care of the large med mal premiums.

[ScoopLV]

Originally Posted by NYtoVT

Agree. So what's the answer ? I don't have one other than the simplistic wage and price controls. Tort reform would take care of the large med mal premiums.

The answer is the same answer when it comes to paying for the federal budget -- which is another immense societal expense.

Nobody is honest about lowering spending in a truly meaningful way. Why? Because the people who have all the power in this country are not paying taxes proportionally to the wealth they control.

If everyone paid their fair share for this bloated, stupid system, then there would be political will to excise this metaphorical tumor of for-profit healthcare, price gouging, and ridiculous lawsuits.

And if everyone paid their fair share of taxes, we'd see some real anger directed toward federal pork projects.

Healthcare and the federal budget are just two heads of the same societal hydra. In both cases we need to work on both spending AND revenue.

[NYtoVT]

So would you say that the for-profit healthcare model is not what this country needs. I would agree. Should then the government take over all aspects of the healthcare system as it would be the only entity capable of such a large undertaking ?. As libertarian as I am, unless a better solution can be found, I would support a government-run healthcare system with no for-profit motive.

[LasVegasPlayer]

Originally Posted by NYtoVT

So would you say that the for-profit healthcare model is not what this country needs. I would agree. Should then the government take over all aspects of the healthcare system as it would be the only entity capable of such a large undertaking ?. As libertarian as I am, unless a better solution can be found, I would support a government-run healthcare system with no for-profit motive.

In a perfect world, maybe. I worry that if we take away the incentive to invent new drugs and for smart people to become doctors, our quality will suffer far more than the money we save, if the govt is capable of running this at all. Look at public hospitals and what Medicaid pays to see what that type of system may look like.

I think a hybrid would appear. We would have HMOs for the rich and upper middle class that provided top care and Medicaid would expand for lower quality care in public hospitals. About 3/4 of hospitals are private these days. Trying to make them all public is a serious undertaking.

[newopty]

Originally Posted by ScoopLV

What part of "inelastic demand" isn't registering?

Since people don't volunteer to die rather than accept treatment that they cannot afford, there has to be some kind of mechanism to make sure the costs are distributed.

Insurance doesn't protect people against catastrophe -- it pays for treatment. That's all it does.

Keep in mind, I'm no fan of ACA. Just put everyone on Medicare and then let insurance companies offer premium plans for HNWIs. (And concierge doctors and hospitals take care for HNWIs.) The rich get what they want. The poor and middle class get what they want. And doctors get what they want. Win-win-win.

I don't know about the rest of you, but I wasn't put on this planet to pay for Emergency Room care for illegal immigrants whose children have the flu. That's not what the ER was designed for. And every property owner (and by extension, renter) pays to keep our ERs afloat with tax revenue. We already pay. We could mandate that ERs CAN turn people away for non-life-threatening treatment, but Urgent Care Clinics cannot. Then we'd pay significantly less for indigents.

I was also not put on this earth to provide funds to keep smokers alive when their health problems inevitably catch up with them. And there are a laundry list of preventable conditions besides smoking that cost us billions each year. Don't like wearing seatbelts? Fine with me. Just as long as I don't have to pay a penny extra in taxes if you go through the windshield. Want to ride a motorcycle on a rainy day? Great! Just make sure nobody has to pay for treatment at UMC after they scrape what's left of you off the pavement with a putty knife.

While I'm no fan of ACA, I can see that it solves more problems than it created. I've watched too many families forced into bankruptcy in order to pay for things like leukemia treatment. So I have zero pity for people who have to pay a few hundred bucks more for health insurance each month -- money that otherwise would be spent on blackjack and cigarettes. Boo-freakin'-hoo for such people.

Most of the forum users claim to be intelligent, fairly good with finances, and even high wage earners. So prove it and sort out your health care. This is not rocket science.

Couldn't disagree more. What you are talking about is what medical insurance has turned into which is one of the reasons it has become so expensive. Insurance isn't intended to cover ever last penny but to make sure the cost doesn't break someone.

[Cold Warrior]

Originally Posted by ScoopLV

Answer: malpractice insurance, medical school tuition, health insurance for everyone from the doctor who performed the surgery down to the receptionist who handled the paperwork, profit for the insurance companies and dividends for their shareholders, the cost of medical supplies (and the complete gouging of the patient for such supplies -- $500 for a bag of saline, for instance), salaries for everyone involved with the hospital, commission for the pharmaceutical reps who sell the drugs.

Get that same operation in Mexico and it's a few thousand instead. Why do you think medical tourism is a thing?

Medical Tourism has indeed become a 'thing', for Canadians, according to a recent report from the Fraser Institute. See Leaving Canada for Medical Care, 2015. Remember, these patients could stay home and receive 'free' healthcare. Here is one reason they leave the country:

One explanation for patients travelling
abroad to receive medical treatment may relate
to the long waiting times they are forced endure
in Canada’s health care system. In 2014, patients
could expect to wait 9.8 weeks for medically
necessary treatment after seeing a specialist–
3 weeks longer than the time physicians consider
to be clinically “reasonable” (6.5 weeks).

[ScoopLV]

Originally Posted by newopty

Couldn't disagree more. What you are talking about is what medical insurance has turned into which is one of the reasons it has become so expensive. Insurance isn't intended to cover ever last penny but to make sure the cost doesn't break someone.

Mine essentially covers every last penny. I pay a token $20 co-pay for just about everything that isn't rhinoplasty and similar.

Any lesser insurance solution means that someone (usually the taxpayers) has to foot the bill for most health issues -- because the patient isn't going to. He or she will run up a whopping tab, and then declare bankruptcy and go on medicaid. That isn't a solution. And that's why the system is broken.

People need to step up and pay their fair share. I pay my fair share and all I get out of it is dental cleanings and an annual checkup. I don't know what will happen tomorrow. So as a responsible member of society, I have my healthcare sorted.

Just like I pay for premium auto insurance even though no company has ever had to pay a dime because of negligence on my part. I pay anyway because it's an uncertain future.

People who want to live like it's the third world (and I have been there and done that), should move to the third world and save the rest of us the bother of dealing with them.

PS -- And I fervently believe that all Libertarians should spend a year in the third world. A year on their own. No support network from Uncle Sam. Nothing will cure that particular broken economic belief system quite like seeing true Libertarianism in action.

[LasVegasPlayer]

^^ One of the reasons for this is a lack of doctors. A Canadian doctor earns about 2/3 what one in the U.S. makes. Socialize the medicine and that will also happen here. People fail to see the big picture of doctor shortages and fewer drug advancements when they push for things like Obamacare and/or a single payer system. The exploding insurance costs are only the first symptom of this debacle. The destruction of the medical research and practices that the entire world depends on is at risk.