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Thread: Your Republican Nominee for 2012

  1. #97
    Senior Member *GSXR~SNAIL*'s Avatar
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    Re: Your Republican Nominee for 2012

    Amen!

    Quote Originally Posted by dirkterrell View Post
    What right is that? You engage in risky behavior, you pay for it. If you have a $2000 pot of money to spend on insurance, preventative care, etc (I'm just making up a number for the sake of argument.) and if you eat right and stay fit, you get to keep $1000 of it at the end of the year. That's an incentive to do the right thing. People are motivated by money.



    That's because there is no downside to the risky behavior. If you know someone else is going to foot the bill, why pay it yourself? People are motivated by money.



    And refusing to pay the cost of something isn't the same as reducing the cost of that something. As I mentioned before, the majority of the increase in spending for health care in the US is due to new technology development. I saw a story last night about a teenage woman who was kept alive by a new machine after her heart failed until a replacement heart could be found. Yes, costs have been going up but the number of people surviving cancer has been going up too. The mortality rates for cancers have been dropping. In the last decade, deaths from coronary heart disease are down by 1/3. All of this with growing obesity rates as Randy referred us to. It's not hard to think that much of the improvement in our ability to treat diseases has come increased spending on developing new technologies, procedures and drugs.



    And in a truly free market, that will happen, just like it does with groceries...

    Dirk
    Liberty never came from government. The history of liberty is a history of resistance. The history of liberty is a history of limitations of government power, not the increase of it. Woodrow Wilson, September 9th, 1912

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  2. #98
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    Wrong goods...groceries does not equal health care. There is no "Walmart" of health care. And we've had this system this way for decades and it's only gotten worse. More bankruptcies, higher costs, more people unable to pay and those costs passed on to us.
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  3. #99
    Chief Viffer Lifetime Supporter dirkterrell's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    Wrong goods...groceries does not equal health care. There is no "Walmart" of health care.
    http://money.cnn.com/2009/04/13/news...ney_topstories

    Dirk
    Formerly MRA #211 - High Precision Racing

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  4. #100
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    lol..wow...thanks. Um that still doesn't fix the high cost of hospital bills which some end up not being able to pay (making them go bankrupt) and the burden ends up being passed to the rest of us via higher premiums, higher hospital charges, etc.

    ...look at the price comparisons for medical procedures. Coronary heart bypass surgery here costs about $200,000, in Belgium the price is $16,000. In the U.S., hip replacement surgery is about $50,000, in France it's $15,000. And a $150,000 bone marrow transplant in the United Kingdom costs up to $400,000 in America.

    From....http://www.kpbs.org/news/2009/aug/04...thcare-part-2/
    Last edited by mtnairlover; Tue Aug 18th, 2009 at 07:29 AM.
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  5. #101
    Chief Viffer Lifetime Supporter dirkterrell's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    lol..wow...thanks. Um that still doesn't fix the high cost of hospital bills which some end up not being able to pay (making them go bankrupt) and the burden ends up being passed to the rest of us via higher premiums, higher hospital charges, etc.
    Yes, but it just shows you how thinking differently about how health care is provided can lead to beneficial things for consumers. Get the overbearing government regulations out of the way and let businesses compete. Yes, the government should continue to play its role of referee by ensuring that consumers are treated fairly and that monopolistic practices are avoided. But the government shouldn't be a competitor in the industry. You can't officiate and play the game at the same time and expect any sort of fairness to occur.

    Quote Originally Posted by mtnairlover View Post
    ...look at the price comparisons for medical procedures. Coronary heart bypass surgery here costs about $200,000, in Belgium the price is $16,000. In the U.S., hip replacement surgery is about $50,000, in France it's $15,000. And a $150,000 bone marrow transplant in the United Kingdom costs up to $400,000 in America.
    Cost versus price can be very different when comparing subsidized procedures versus a market approach that is weighted down by government accounting regulations, litigation insurance, inadequate competition, etc. Do these foreign prices include the subsidized monies? I pointed out before about my own experience "competing" with government labs. Our costs seemed pretty high until the government labs had to do full cost accounting. Now we seem like a bargain.

    Dirk
    Formerly MRA #211 - High Precision Racing

    "A strict observance of the written laws is doubtless one of the high duties of a good citizen, but it is not the highest. The laws of necessity, of self- preservation, of saving our country when in danger, are of higher obligation. To lose our country by a scrupulous adherence to written law would be to lose the law itself, with life, liberty, property, and all those who are enjoying them with us; thus absurdly sacrificing the end to the means."

    --Thomas Jefferson



  6. #102
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    Right now, I don't have time to completely interpret and break down that article/interview and make a nice bite-able piece, because there is so much to the way we do health care, that it's just huge. You can't get a whole lot from the snippet I posted...that's why I linked the article and that article is Part 2 in a series.

    Here's another snippet and this guy describes why our costs are so high...and this is only a portion of the 8 reasons he listed...

    FUCHS: I’d start off with administrative costs. We spend a lot more on administration than other countries do and that’s because of the way we finance medical care and the way we pay the people who provide it. Apart from the elderly, the under 65 population gets their insurance mostly through employment-based insurance or through Medicaid, an income-tested insurance. And both of those systems are very expensive to collect. There are very large administrative costs. And then we pay mostly on a fee-for-service piecework basis, which means millions and millions of separate little items have to be billed for. So I would say administrative costs are a big difference. Second is the high ratio of specialists to primary care physicians. For example, in Canada, which is a country very similar to ours in many ways, they have about a fifty-fifty break between specialists and primary care. In the United States, there are about 70% specialists and about 30% are primary care. Now specialists are more expensive to train, more expensive when they’re treating people, and they tend to use more expensive procedures. Third would be we do a lot more of certain expensive procedures like MRI scans. Again, a comparison with Canada is instructive, that we do almost three times as many MRI scans per capita as Canada does. Another reason is we have more standby capacity for expensive equipment and personnel. Again, using MRI as an example, in the United States, there are more than four times as many MRI machines as there are in Canada. Given the fact that we do a little less than three times as many scans, it turns out that in Canada, each machine does about 50% more scans than in the United States, so they’re getting more intensive use of their expensive equipment. We have mostly open-ended funding. We don’t have fixed budgets. In most of the other countries, they have fixed budgets for health care.

    Oh yeah...and this guy is a professor on economics and an expert in health policy.

    I never said anything about government run health care...all I said is that if that's one of the things that needs to be done...if we need to have another choice, then so be it, because something needs to be done to change the way our health care system is run. People need to look at it in detail and figure out the best way to do things...leave out the idea of "competition" for a moment, because it's more than just $$$ we are dealing with...it's people's lives in a whole lot of cases. How can anyone put a dollar amount on that? And yet, people get turned away at the door when they are in need and can't pay. Sorry, leave out my emotional outburst. Back to the issue...is it a business? Yes...but, it is a business set out to help people become healthy. Change the way the system thinks about how to make people healthy. Change the focus of the business...instead of fixing...think about maintenance and preventing.
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  7. #103
    Senior Member JustSomeDude's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    leave out the idea of "competition" for a moment, because it's more than just $$$ we are dealing with...it's people's lives in a whole lot of cases. How can anyone put a dollar amount on that? And yet, people get turned away at the door when they are in need and can't pay.
    Actually- that's exactly what the government will do. You complain that it is being done under a private system already, and that somehow actuarial tables will be miraculously better applied by the blessed all powerful United States Government... LORD HAVE MERCY! It's funny how the left, who are surprisingly anti-religious, always seem to have the utmost faith in government (I never understood why). More so than most religious fanatics. A cute little paradox there.

    If you think apply dollar values to human lives isn't being done already, why don't you investigate the N.I.C.E. Panel (clever name) in England. They place dollar values on human lives. If the treatment will not be paid back by the anticipated life-extension it may provide to the patient, the treatment is denied and the patient (in a best-case scenario) is provided pain-killers until they die, thus ridding England of their unnecessary cost-burden. Classy, eh?

    Contrary to your post, no hospital emergency room can deny care. If some one doesn't have money for a treatment, they do NOT get denied, they simply go into debt. If you are in an accident, or need emergency treatment, you will get it. As for the "poor", we already have THOUSANDS of programs in place in all of our states and municipalities to cover treatments for those who can't pay... at taxpayer expense, or at a operating loss to the hospital.

    As for the cost - costs will not be controlled by the legislation currently being proposed... and even if it DOES go up, what does THAT mean? The United States government already spends more than ANY other country on things like welfare, unemployment, education, etc. etc. etc. Yet where are the results? I could go on all day listing how the US Gov't is the "best" with respect to money spent per person - yet how the results are garbage compared with much poorer countries on the planet. Yet you want to increase spending a few trillion fold on healthcare to, what, make us MORE independent and self-reliant? Yeah - right.

  8. #104
    Chief Viffer Lifetime Supporter dirkterrell's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    Right now, I don't have time to completely interpret and break down that article/interview and make a nice bite-able piece, because there is so much to the way we do health care, that it's just huge. You can't get a whole lot from the snippet I posted...that's why I linked the article and that article is Part 2 in a series.
    Yeah, I read the whole thing. I just wanted to understand what numbers we were comparing since that wasn't elucidated in the transcript. They might be meaningless or they might be useful but we don't know which unless we know what they represent. There is too much rhetoric in this whole health care debate fueled by misunderstood numbers and "death panels."

    Quote Originally Posted by mtnairlover View Post
    Here's another snippet and this guy describes why our costs are so high...and this is only a portion of the 8 reasons he listed...

    FUCHS: I’d start off with administrative costs. We spend a lot more on administration than other countries do and that’s because of the way we finance medical care and the way we pay the people who provide it.


    I wonder how much government paperwork contributes to this inefficiency? Fair competition decreases overhead costs.

    Quote Originally Posted by mtnairlover View Post
    Apart from the elderly, the under 65 population gets their insurance mostly through employment-based insurance or through Medicaid, an income-tested insurance. And both of those systems are very expensive to collect. There are very large administrative costs. And then we pay mostly on a fee-for-service piecework basis, which means millions and millions of separate little items have to be billed for.


    I need to look into why it's done this way but I suspect it's because the government requires such detailed accounting for Medicare/Medicaid reimbursements. I see such requirements in my own job. It's a waste of time but that's the way government-run things evolve, towards more and more detail in reporting.

    Quote Originally Posted by mtnairlover View Post
    So I would say administrative costs are a big difference. Second is the high ratio of specialists to primary care physicians. For example, in Canada, which is a country very similar to ours in many ways, they have about a fifty-fifty break between specialists and primary care. In the United States, there are about 70% specialists and about 30% are primary care. Now specialists are more expensive to train, more expensive when they’re treating people, and they tend to use more expensive procedures.


    But does that provide better services for patients? Could this be a reason why people from other countries come here to have special procedures done?

    Quote Originally Posted by mtnairlover View Post
    Given the fact that we do a little less than three times as many scans, it turns out that in Canada, each machine does about 50% more scans than in the United States, so they’re getting more intensive use of their expensive equipment.


    Sounds like a market that needs more competition.

    Quote Originally Posted by mtnairlover View Post
    We have mostly open-ended funding. We don’t have fixed budgets. In most of the other countries, they have fixed budgets for health care.
    Fixed budgets may simplify the economic side of things but you have to wonder what it does for the care side of things.

    Quote Originally Posted by mtnairlover View Post
    Oh yeah...and this guy is a professor on economics and an expert in health policy.
    And I don't disagree with many of the things he's saying, which are mostly factual things about the situation. The big question is why things are the way they are and what is the best way to proceed.

    Quote Originally Posted by mtnairlover View Post
    I never said anything about government run health care...all I said is that if that's one of the things that needs to be done...if we need to have another choice, then so be it,
    Yes, but that particular approach is fraught with damaging consequences that would eventually bring us down. Competition brings down costs. Government regulation increases them.

    Quote Originally Posted by mtnairlover View Post
    because something needs to be done to change the way our health care system is run. People need to look at it in detail and figure out the best way to do things...
    Agreed. That is what I am trying to do.

    Quote Originally Posted by mtnairlover View Post
    leave out the idea of "competition" for a moment, because it's more than just $$$ we are dealing with...it's people's lives in a whole lot of cases. How can anyone put a dollar amount on that?
    You mean like setting arbitrarily fixed budgets?

    Quote Originally Posted by mtnairlover View Post
    And yet, people get turned away at the door when they are in need and can't pay. Sorry, leave out my emotional outburst. Back to the issue...is it a business? Yes...but, it is a business set out to help people become healthy. Change the way the system thinks about how to make people healthy. Change the focus of the business...instead of fixing...think about maintenance and preventing.
    And I agree with you there. But that also requires effort from the insured to do the things they can do to make themselves healthier. And the best way to modify behavior is to give people a monetary incentive to do so (e.g. my idea of an allocation of money, tax credit perhaps, that they can keep more of by living a healthier lifestyle). If you just lump everyone together cost-wise, then there is no incentive to do things that reduce the country's health care costs.

    Dirk
    Formerly MRA #211 - High Precision Racing

    "A strict observance of the written laws is doubtless one of the high duties of a good citizen, but it is not the highest. The laws of necessity, of self- preservation, of saving our country when in danger, are of higher obligation. To lose our country by a scrupulous adherence to written law would be to lose the law itself, with life, liberty, property, and all those who are enjoying them with us; thus absurdly sacrificing the end to the means."

    --Thomas Jefferson



  9. #105
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by dirkterrell View Post

    Sounds like a market that needs more competition.

    Fixed budgets may simplify the economic side of things but you have to wonder what it does for the care side of things.

    Yes, but that particular approach is fraught with damaging consequences that would eventually bring us down. Competition brings down costs. Government regulation increases them.
    Um...nope...


    • Increased competition resulted in consolidation of providers and higher charges for consumers who were not part of large managed care plans. With the end of rate regulation in 1992, only two payer classes still paid full hospital charges: the uninsured and the commercially insured. Competitive hospital pricing may, in fact, have jeopardized access to care for the most financially vulnerable.
    • A comparison of hospital profits between the regulated period and the deregulated period showed that profits were higher during the regulated years.

    The investigators noted that for the large purchasers of health care services, deregulation was simply a continuation of a trend begun in the 1980s, when area HMOs gained sufficient size to negotiate substantial hospital discounts and affect hospital utilization by shifting volume to preferred providers. The study findings indicate that hospital discounts to HMOs in Worcester were significant, and that HMO business was at least temporarily subsidized by Medicare profits and profits earned under the state-regulated payment system.

    This was an article on the end of rate regulation in Massachusetts...the same thing happened there as did with New York when it ended regulation in '96...higher costs to the consumer.

    http://www.rwjf.org/reports/grr/023465.htm
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  10. #106
    Chief Viffer Lifetime Supporter dirkterrell's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    Um...nope...


    • Increased competition resulted in consolidation of providers
    Check out this telling bit of information from that link:

    Medicare payment policy, specifically indirect medical education payments, may have inadvertently created significant competitive advantages for teaching hospitals compared to community hospitals, which steadily lost market share. The major teaching hospitals emerged as the dominant providers in the area, with the bulk of resources and market share.
    So, the government's influence gave one section of the market a "significant competitive advantanges." Hardly sounds like a level playing field. That's the problem with these so-called "free market" tests that everyone says show that it doesn't work: current laws and regulations seem to make it impossible to have a truly free market system for health care because the government specifies who you, the consumer, can do business with (e.g. insurance) and what products the providers can offer.

    Dirk
    Formerly MRA #211 - High Precision Racing

    "A strict observance of the written laws is doubtless one of the high duties of a good citizen, but it is not the highest. The laws of necessity, of self- preservation, of saving our country when in danger, are of higher obligation. To lose our country by a scrupulous adherence to written law would be to lose the law itself, with life, liberty, property, and all those who are enjoying them with us; thus absurdly sacrificing the end to the means."

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  11. #107
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    Exhibit 6.11: Private Health Insurance Administrative Costs per Person Covered, 1986-2003
    The cost per enrollee for private health insurance expenses not related to direct care services (such as administrative costs and profits) continued to rise, from $85 in 1986 to $421 in 2003. The most rapid growth occurred in the 4-year period from 1987 to 1990, when these administrative costs rose 125%. For the six-year period from 1998 to 2003, administrative costs per enrollee nearly doubled (+95%).


    http://www.kff.org/insurance/7031/ti2004-6-11.cfm

    I didn't find too much mention of government paperwork being the problem with costs. It was the administrative costs, including insurance company paperwork requirements.

    Underlying administrative costs, which are part of all hospital, physician and pharmaceutical spending, are also to blame. In 2002, 13 percent of premium dollars went toward insurance companies' administrative costs, including salaries, advertising and profits.

    Hospitals, which have faced recent labor shortages, are competing for nurses and other hard-to-find professionals by offering higher salaries and bonuses. Pharmaceutical companies are spending money not just on research and development, but on TV ads urging consumers to "ask your doctor" about new medications. Physicians are paying billing companies to handle complicated insurance paperwork.

    When these costs go up for health care providers, so do insurance premiums.


    http://www.signonsandiego.com/news/h...n22health.html

    Also mentioned was the fraud and lawsuits that increase costs.

    Like I keep saying...fix the system...it ain't working. It isn't just one thing either. Find the waste and streamline the processes (everywhere). As a result, you lower costs to the consumer and you open up the market to those who are uninsured and can't afford insurance. Initial outlay may be a tad up there, but in the long run, profits will be higher, because you've cut out the waste.

    Here's one group of Doctor's answer to the insurance company strangle-hold:

    http://www.sfgate.com/cgi-bin/blogs/...entry_id=43390
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  12. #108
    Chief Viffer Lifetime Supporter dirkterrell's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by mtnairlover View Post
    I'm having trouble getting to the rest of that document (looks like a web server issue) but I'll keep trying.

    Quote Originally Posted by mtnairlover View Post
    Like I keep saying...fix the system...it ain't working. It isn't just one thing either. Find the waste and streamline the processes (everywhere). As a result, you lower costs to the consumer and you open up the market to those who are uninsured and can't afford insurance.
    But to fix it, we have to figure out what the problems are. I don't trust what politicians on either side say because they have motivations that really don't have anything to do with whether we have a well-functioning health care system. I take what all sides (insurance companies, health care providers, etc) say with a grain of salt. I want to avoid the emotional cries and get at the facts. None of these people want fair competition. They want whatever gives them an advantage. I want the government to ensure that the competition is fair and then the optimal solution will come about.

    Quote Originally Posted by mtnairlover View Post
    Here's one group of Doctor's answer to the insurance company strangle-hold:

    http://www.sfgate.com/cgi-bin/blogs/...entry_id=43390
    Yes, that's exactly the kind of thing I like to see. Check out the link on that page to the "previous Doc Gurley SFGate article". A very telling statement in there:

    It didn't take long for insurance companies to notice. Their ploy? To accuse these individual docs of falsely pretending to be, and act as, insurance companies, and - therefore, not complying with the massive regulations that it takes to compete as an insurance company.
    Now, if the insurance companies are being underhanded, then that should come out in the process. But if they are being unfairly stifled by excessive government regulations that don't apply to others, then they have a legitimate complaint. Personally, I'd rather see insurance companies provide the catastrophic illness/injury protection while your day-to-day cold, sore throat, preventative care, etc done by providers like the clinics you referenced and paid for by the individuals.

    Dirk
    Formerly MRA #211 - High Precision Racing

    "A strict observance of the written laws is doubtless one of the high duties of a good citizen, but it is not the highest. The laws of necessity, of self- preservation, of saving our country when in danger, are of higher obligation. To lose our country by a scrupulous adherence to written law would be to lose the law itself, with life, liberty, property, and all those who are enjoying them with us; thus absurdly sacrificing the end to the means."

    --Thomas Jefferson



  13. #109
    Gold Member Yearly Supporter mtnairlover's Avatar
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    Re: Your Republican Nominee for 2012

    Quote Originally Posted by dirkterrell View Post
    I'm having trouble getting to the rest of that document (looks like a web server issue) but I'll keep trying.

    But to fix it, we have to figure out what the problems are. I don't trust what politicians on either side say because they have motivations that really don't have anything to do with whether we have a well-functioning health care system. I take what all sides (insurance companies, health care providers, etc) say with a grain of salt. I want to avoid the emotional cries and get at the facts. None of these people want fair competition. They want whatever gives them an advantage. I want the government to ensure that the competition is fair and then the optimal solution will come about.
    That's what the government should do...ensure fairness in competition. It's not happening. Not with the things I've found. Insurance companies do what they want because they can, just as much as the pharmaceutical companies do. Left to their own guises, some companies will fail the consumer. That's because "people" run the companies and people are not infallible. As proof, just check out the most corrupt state in the union today...http://www.nj.com/news/index.ssf/200..._sweep_re.html No one is immune at any level from the potential of becoming corrupt...not without some good and fair regulation/whatever you want to call it.

    Oh the corrupt link is to the Kaiser Family Foundation's studies in health care. See if this link works...http://www.kff.org/insurance/7031/ti2004-1-1.cfm. The link should take you to a bar graph and then there's 21 more graphs, charts and pie charts that depict cost increases in many different sectors of health care.

    Oh yeah...and corruption is not solely a governmental phenomenon...http://nbalawblog.com/2009/07/06/ins...-ex-executive/

    I keep finding them...fraud and anti-competitive practices...http://www.consumeraffairs.com/news04/ny_insurance.html
    Last edited by mtnairlover; Tue Aug 18th, 2009 at 08:30 PM.
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