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AverageUser
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RE: Health Care Reform Passed (Part 3)

Mon Apr 05, 2010 10:34 pm

Quoting Dreadnought (Reply 44):
Those costs exist because of our perverted system where the person who pays the bill is not the same person as who receives the service. Fix that and you fix the pricing.

Have I mentioned national single-pool insurance any time lately?
 
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Dreadnought
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RE: Health Care Reform Passed (Part 3)

Mon Apr 05, 2010 10:44 pm

Quoting AverageUser (Reply 50):

Have I mentioned national single-pool insurance any time lately?

You mean, handing over the management of our healthcare completely to the same entity which has run Social Security, Medicare, Medicaid, public pensions, public schools, national energy policy, Fannie Mae & Co., Defense procurement, and other programs so well that we are now looking at a $120 trillion deficit in the coming years, while producing very lackluster results in the process?

Sure, of course, why not?

     
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dxing
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RE: Health Care Reform Passed (Part 3)

Mon Apr 05, 2010 11:10 pm

Quoting FlyPNS1 (Reply 48):
Do you really think that business model will work with doctors? How many more patients do you really think a doctor can see? Many don't spend enough time with their patients as is and you expect them to go to an even higher volume and lower margin.

Well get ready because that is exactly the premise behind Obamacare. Lower premiums means more people can afford insurance which means more people get to see the doctor which means lower patient face time. If you suddenly drop 15-50 million (the number seens to change based on which rotating speech the President is using) into the system without raising the level of doctors, nurses, techs, or facilities, while giving those new patients full access what would you expect to have happen?

Quoting FlyPNS1 (Reply 48):
Despite that, the cosmetic surgery market caters only to the middle and upper brackets of income. I'm sure there are many poor people who would like cosmetic surgery, but they are simply priced out of the market.

I just can't wait to hear about the frist woman that got her elective boob job courtesey of the taxpayer.

Quoting AverageUser (Reply 50):
Have I mentioned national single-pool insurance any time lately?

As well as it may work in Finland all you have to do is look at the deals that were cut and the advantages that politicians here took while the legislation was being formed to understand that our government is made up of individuals that are out for two things, re-election and personal power. Those do not tend to work well in creating a system that will actually work as intended or for the people.
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Dreadnought
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RE: Health Care Reform Passed (Part 3)

Mon Apr 05, 2010 11:13 pm

Quoting DXing (Reply 52):
I just can't wait to hear about the frist woman that got her elective boob job courtesey of the taxpayer.

Well, to be fair I for one fully support better tits for the entire female population.  
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FlyPNS1
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 3:35 pm

Quoting Dreadnought (Reply 49):
According to the American Society of Plastic Surgeons, the national average fee for breast augmentation in 2005 was $3,406.

When you consider the relative simplicity of the procedure, that's a pretty high price. Remember, that is only the surgeon's fee for a procedure that lasts barely an hour.

Quoting Dreadnought (Reply 49):
But for breast reduction, the average is $7,200, more than double. I would suggest that the difference is that the first is purely voluntary, and the second is often covered by insurance.

Insurance may be part of it, but breast reduction is a more complex procedure as well.

But the bottomline is that free-market healthcare will still be very expensive. If the free market determines the price, many will simply be priced out. If you are fine with a chunk of the population having no healthcare (and the ensuing societal costs), then I'll absolutely agree with you to let the free market run the show.

Quoting DXing (Reply 52):
Those do not tend to work well in creating a system that will actually work as intended or for the people.

But is that really any different from most of the private sector? Most people in the private world are driven mostly by a desire for wealth and power. Do you think the CEO of Lehman Brothers cared if he destroyed part of the U.S. economy with his dubious business practices? Of course not. He only cared about maximizing profits for himself.
 
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 3:49 pm

Quoting FlyPNS1 (Reply 54):
But is that really any different from most of the private sector? Most people in the private world are driven mostly by a desire for wealth and power. Do you think the CEO of Lehman Brothers cared if he destroyed part of the U.S. economy with his dubious business practices? Of course not. He only cared about maximizing profits for himself.

The difference being in that the officials in the private sector are not elected to serve the people.

On top of that there is a whole threads worth of discussion leading up to who enticed whom to get into those types of business practices. The blame cannot be laid entirely at the private sectors feet.

In the health insurance market a certain percentage of every premium dollar must go towards payment of health care. In most States it's somewhere on the order of 75-25 with the 75 being health care dollars. In Calinfornia it is 78%. In New Mexico they just changed the law to require large group providers spend 85% on direct payment for health care. Only small group and individual providers get a break at 75-25.

http://albuquerque.bizjournals.com/a...1/story3.html?b=1267419600^2946191

If anyone needs a primer on how politicians do their math, here it is:


“The folks at our Insurance Division [of the Public Regulation Commission] told me that 85 percent is the average number for what goes into actual health care services in the state,” Heaton said. “Some are at 80, 84 and 83, and so the average is about 85 percent.”.

Exactly how would 80, 83, and 84, even if there are some 85's average 85%?


So you are comparing apples to walnuts when you compare Lehman Brothers to Blue Cross.
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AGM100
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 4:13 pm

Quoting Dreadnought (Reply 47):
There are too many people involved who are perfectly willing to pass the cost on to someone else. That's what has to stop if the costs are supposed to be controlled.

Correct ... and the governemnt is there with the deep pockets to cover all the issues. Same thing happening in higher education right now ... the governemnt is thier to back anyone who wants to go . It only raises the fees for everyone in the end. It does exactly the opposit of what the liberals intend it to do.
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 4:48 pm

Quoting DXing (Reply 55):
The difference being in that the officials in the private sector are not elected to serve the people.

They can be removed if the public isn't happy with them. Oddly though, the public seems to always replace them with someone that is equally as bad.

It's actually much harder to get rid of many rotten CEO's and usually requires paying them millions of dollars to go away.

Quoting AGM100 (Reply 56):
Same thing happening in higher education right now ... the governemnt is thier to back anyone who wants to go . It only raises the fees for everyone in the end.

But it's the same problem as health care. If the government steps out of it, prices may come down a little, but a large swath of the population will be priced out of higher education. As before, if you think its ok for a large chunk of the population to lose access to higher education, then sure get the government out. If you want those of lesser means to have access to higher education, then some intervention will be necessary.
 
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 5:04 pm

Quoting FlyPNS1 (Reply 57):
If you want those of lesser means to have access to higher education, then some intervention will be necessary.

Their is not one person in this country who ..if they work hard and dream of going to college can not get there. Is it easy? ...hell no ... will you better off earning it? ... hell yes. That is what holds our system together.... if you give it away it will become cheap and useless. We will end up with millions of "college educated" people who dont know what to do with it because they lack the fundamental ground work that is most important to a career .... self motivation and toughness.
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Starbuk7
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 6:44 pm

Quoting AGM100 (Reply 58):
We will end up with millions of "college educated" people who dont know what to do with it because they lack the fundamental ground work that is most important to a career .... self motivation and toughness.

I agree totally, ther eare a lot of people in this country who no longer know what it means to work for something. Thay all expect to get everything handed to them on a silver platter. That is the biggest problem with this country today is it is becoming a country of entitlements. Not a good thing. I feel very proud to have worked for everything that I have in my life.
Including Health Insurance. I don't feel the need to pay for anyone else. They can work hard for themselves and purchase their own insurance WITHOUT any assistance.
 
dxing
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RE: Health Care Reform Passed (Part 3)

Tue Apr 06, 2010 10:27 pm

Quoting FlyPNS1 (Reply 57):
They can be removed if the public isn't happy with them.

The stockholders of the company can demand a CEO's removal but only the BOD can vote for a CEO's removal. Quite different from a Senator or Congressman.

Still apples to walnuts
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FlyPNS1
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 12:43 am

Quoting DXing (Reply 60):
The stockholders of the company can demand a CEO's removal but only the BOD can vote for a CEO's removal. Quite different from a Senator or Congressman.

All the more reason why leaving this country's future in the hands of CEO's is a dangerous proposition. They have NO accountability for their actions except to a BOD which is usually loaded with their own cronies.

Quoting AGM100 (Reply 58):
That is what holds our system together.... if you give it away it will become cheap and useless.

I'm not advocating giving it away, but rather ensuring that those who work hard will actually have access. Without government intervention to subsidize loans (as well as subsidize public universities/junior colleges), many of those hard workers would never attend college no matter how hard they worked.
 
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Dreadnought
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 1:20 am

Quoting FlyPNS1 (Reply 61):
I'm not advocating giving it away, but rather ensuring that those who work hard will actually have access. Without government intervention to subsidize loans (as well as subsidize public universities/junior colleges), many of those hard workers would never attend college no matter how hard they worked.

Not true. Scholarships have been available for deserving students for ages. There is the GI Bill. Anyone who really wants to continue their education have been able to do so if they really wanted to. Millions of scholarships are awarded every year.

Quoting FlyPNS1 (Reply 61):
All the more reason why leaving this country's future in the hands of CEO's is a dangerous proposition. They have NO accountability for their actions except to a BOD which is usually loaded with their own cronies.

And government is much better? All they need to do is behave themselves and hand out pork for the 6-8 months of campaigning before an election, and the rest of the time he can do what he pleases, no matter how stupid or corrupt. A business is not held to an election cycle - a CEO can be fired at any time, as soon as the shareholders decide that he's not doing what they want. If we could do that not most of our Congress would be gone right now.
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AirStairs
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 3:42 am

Quoting Ken777 (Reply 32):
It's amazing how you'll prefer to have the finance sector free to play the same games that caused to many problems rather than have a Democrat, especially a gay Democrat, work to get some control over the area.

Right, because Frank's genius policy of forcing banks to make housing loans to bad credit risks and then charging Fannie and Freddie with the moral duty of guaranteeing such loans was genius, really provided us with some substantive control over the financial sector and did not at all contribute to the bubble in housing prices, the ensuing collapse and the current spate of foreclosures. As a homosexual who has oddly enough met Barney Frank at a gay bar (and I resent that you bring it up anyway, because his gayness has nothing to do with it), I will not ignore that Democratic lawmakers structured legal institutions in such a way that mandated (or at the very least incentivized) banks to write loans they knew were bad, because they would be immediately guaranteed by Fannie and Freddie and resold. All in the name of economic justice, because apparently renting is the great injustice of the 21st century.

Why do you continue to blame "greedy Wall Street CEOs" for this entire mess? The ones who perpetrated fraud or cooked books of course should be prosecuted, but most were simply acting as any rational agent would given the legal environment and economic incentives that the legislature put into place.

So you're right, I would rather have the finance sector play their games than have this gay Democrat, with his dismal record of economic understanding, to work to get some control over the area.

Quoting Ken777 (Reply 35):
Fortunately not - some Americans would have lost a huge amount when the Dow went from 14000+ to the 6000 range.

Aside from the fact that nearly all of those would be paper losses unless you were dumb enough to sell at the bottom, the point of privatization is that you choose to put it where you like. If the stock market is to risky for your appetites, buy some T bonds. Or stash it in a CD. Or invest in your neighbor's lawn mowing business. Or put it under the mattress. Most people choose the stock market because empirical data show time and again that stocks offer the greatest growth with relatively low risk in the long term, even accounting for recessions like the most recent one. If you think that is just corporatist propaganda then put your money elsewhere.

Quoting Ken777 (Reply 35):
So basically the elderly in this country has been protected during a massively unstable time in the financial sector.

Yeah except any senior who has access to google.com is going to have a very low exposure to equities by the time he even thinks about retirement. They would be heavy into fixed income (before Obama stomped on bondholder's rights), savings bonds, and cash depending on their tax situation.

Quoting DXing (Reply 41):
Then following free market rules the prices will fall accordingly. BTW, it's not the insurance companies that set the "health care" costs, that's doctors, hospitals, drug and medical equipment/supply companies.
Quoting FlyPNS1 (Reply 43):
Quoting DXing (Reply 41):
Then following free market rules the prices will fall accordingly.

No, healthcare will simply become a luxury good that only the well-off can afford.

That is only true if we continue to allow them to enjoy anti-trust immunity. Selling across state lines is important, but not the whole story. We must make the insurance companies compete with one another. Just like in every other market, if a firm A goes wild with prices, firm B is going to swoop in and pick up the lower end not out of benevolence but because there is profit potential.

Again, even true competition is not the only remedy but it is a necessary first step that the Democrats have very notably not addressed, all the while stoking the populist rage at insurance companies.

Quoting FlyPNS1 (Reply 43):
I never said that insurance companies "set health care" costs. However, they can influence costs...both positively and negatively.

But in a competitive market, firms actually have very little pricing power. Without ATI, the insurance market might not be perfectly competitive because of the high costs to set up shop, but in principle it would actually mitigate the ability of insurance companies to influence costs.

I trust this solution much more than giving them the power to influence costs positively or negatively and then expecting them to act contrary to their economic interests.

Quoting Dreadnought (Reply 44):
Those costs exist because of our perverted system where the person who pays the bill is not the same person as who receives the service. Fix that and you fix the pricing. Fix the pricing and you reduce the costs for the 80-90% or more of the population who can afford the insurance.

   True competition and a system in which the consumer of the service is actually accountable for its cost will significantly reduce our cost problems. Any kind of insurance creates moral hazard problems, to address this we must have the consumers of health care pay a percentage of their health care costs such that they actually have to consider cost, economize, and determine what treatments are worth it to them.

Under the current system, even a rational patient has every economic incentive to undergo every single test, procedure or service they can get their hands on, so insurance companies do the economizing and I would agree with many liberals that it is not particularly effective. Because each person has a different utility for most procedures, I would rather leave the decision making up to the individual. But that is impossible as it stands now because the incentive is to vastly overconsume.

I am not immune from the phenomenon. Just last week a had a procedure and had to be put under. I hate IVs, and was not looking forward to being hooked up, so the nurse offered me a valium. Knowing my costs are the same whether I take the pill or not, I gladly accepted. But had I been even marginally accountable for the cost of that pill I would have at least thought about whether it was really worth the cost.

Quoting DXing (Reply 45):
Another thing that could greatly help, and not cost the taxpayer a dime, is to get hospitals and doctors to list their prices for particular services so you could shop for your services. That does not mean decreasing standards, but having a more transparent system of pricing. Right now virtually anyone who has insurance has no idea how much it costs to go to the doctor other than their co-pay and they probably don't really care.

   I agree. I am not too familiar with what regulations exist already but this should be mandatory. I know that network agreements complicate things as far as transparency, but you should at least be provided with a quote when you go through hospital registration and your insurance is verified.

Quoting FlyPNS1 (Reply 46):
And those price levels will be out of reach for a significant portion of the population
Quoting Dreadnought (Reply 47):
Complete supposition on your part. Prices are high now because doctors and hospitals can get away with it because the Insurance companies are willing to pay them, the employers are willing to pay the insurance premiums and pass on the additional expense to their customers, or the government who can raise taxes or borrow money. There are too many people involved who are perfectly willing to pass the cost on to someone else. That's what has to stop if the costs are supposed to be controlled.

Agreed, the prices now really have nothing to do with costs because hospitals routinely jack up prices to compensate for the deeper and deeper negotiated discounts which insurance companies win through monopsony power (another unfortunate consequence of ATI). If a hospital billed $1,000 before and then an insurance company negotiated a 50% discount, the hospital will simply raise the price to $2,000 to keep that revenue. It is common for insurance companies to pay doctors and hospitals less than 30 cents on the dollar of what is billed. So over the span of decades we get $1,000 toothbrushes.

Medicare is happy to underpay on just about anything and pass the cost to doctors and hospitals, who pass it to insurers, who, you guessed it, pass it to customers and their employers.

Quoting AverageUser (Reply 50):
Have I mentioned national single-pool insurance any time lately?

Except that still does not confront issues of cost. If you think large insurance companies have unfair power to set prices, just wait until you start dealing with the government. It is not a big secret that Medicare pays out under cost, so unless you want to make the government negotiate payout rates in good faith without using legislative power (not going to happen) or come back to the drawing board in a couple of decades when hospitals can't afford to stay open (been to France lately?), this is simply not a solution.

Quoting FlyPNS1 (Reply 54):
But the bottomline is that free-market healthcare will still be very expensive. If the free market determines the price, many will simply be priced out. If you are fine with a chunk of the population having no healthcare (and the ensuing societal costs), then I'll absolutely agree with you to let the free market run the show.

It is much more prudent to let the free market run most of the show (with the conditions above that they compete across state lines, emphasize HSAs to increase consumption accountability, and do not enjoy ATI) and have a catastrophic/safety net for those who are impoverished than it is to create these odd incentives and convoluted mandates to prop up a policy that otherwise couldn't stand on its own two feet.

Quoting FlyPNS1 (Reply 57):
They can be removed if the public isn't happy with them. Oddly though, the public seems to always replace them with someone that is equally as bad.

There is a fundamental problem with that assumption, mainly that individual citizens have any kind of control over who is in office. Individuals have no influence over the options they are given to choose from in elections, which is why bad is almost always replaced with bad. Candidates are put forward by self-interested party machines and so we are often forced to choose between the lesser of two evils.

An individual has a lot more power in a competitive market where he can vote with this wallet than under a public system where his money is legally bound to the provider (there are no other alternatives) and he has a 1/309,016,959 chance of having his voice heard, much less given any weight. If you think CEOs are out of touch, try reasoning with a career bureaucrat or civil servant who enjoys the ironclad protections of government employment. At least you can hold CEOs accountable by withdrawing your money.

Quoting FlyPNS1 (Reply 57):
But it's the same problem as health care. If the government steps out of it, prices may come down a little, but a large swath of the population will be priced out of higher education. As before, if you think its ok for a large chunk of the population to lose access to higher education, then sure get the government out. If you want those of lesser means to have access to higher education, then some intervention will be necessary.

And I think our solution to healthcare should approach the one we have taken toward higher education. Under a "single-payer" education system, any rational person would choose to go to his more expensive, prestigious option over his state school, live in the nicest dorms, go on the study abroad trips, take the expensive classes with lab fees, buy new instead of used textbooks, and so on. Costs would skyrocket and resources would be completely misallocated. Then the news of the cutbacks would come.

Consumers have to be exposed to the costs of their economic decisions so that our society can allocate them to those with the highest utility. It is true that many get priced out of the market, as we are seeing with higher education, but the solution isn't to take over and pay for everyone, it is to means-test financial assistance in order to help get people to where they "belong" in the system, while still exposing them proportionally to the costs of their decisions. In principle, I actually don't like the practice because it creates harmful disincentives itself, but there is evidence that the negative externalities for all of society from an undereducated or seriously unhealthy population may be more costly than providing means-tested aid for the very poorest.
 
dxing
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 4:35 pm

Quoting FlyPNS1 (Reply 61):
All the more reason why leaving this country's future in the hands of CEO's is a dangerous proposition. They have NO accountability for their actions except to a BOD which is usually loaded with their own cronies.
Quoting Dreadnought (Reply 62):
A business is not held to an election cycle - a CEO can be fired at any time, as soon as the shareholders decide that he's not doing what they want. If we could do that not most of our Congress would be gone right now.

   In most cases if you are in the private sector and don't get the job done, you're gone. Not so in Congress. As long as you can blame the other party or portray your opposition in some unfavorable light, true or not, then as an incumbent you're pretty safe. Hopefully voter outrage has reached the point this election cycle where that will change. It's not too late to stop the rest of the stimulus spending and change the health care law to something that actually does something to control costs instead of just increase government power and control.

[Edited 2010-04-07 09:36:18]
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AGM100
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 4:58 pm

Quoting FlyPNS1 (Reply 61):
Without government intervention to subsidize loans (as well as subsidize public universities/junior colleges), many of those hard workers would never attend college no matter how hard they worked.

What other country in the world has had millions of poor kids rise to the levels that we have?. None. Millions of lower middle class and poor kids have strove to achieve and made it out of their situation. See the problem with the lefties running it now is that they do not believe in the American dream .... they just dont understand it.

I am not saying that some grants and governemnt programs are not warranted ... but a governemnt student loan industry ? Your governemnt is loaning money now ? As a tax payer I want to make sure that the only people getting my money to go to college are ones that deserve it .... We need a federal review board to decide who gets to go thats all I want.

Back to health care ....

If they are going to use my money to spread around to treat other people ... I want cost review panels at the federal level. I want to make sure my tax dollars are not being wasted by unnecessary treatments ...tests and other expensive medical proceedures for those that could do without it. I dont think that I should pay for a hip replacement for a 65 year old guy so that he can go play golf and be comfortable at the bridge table. Their should be some level that we have to cut off care or dispence lesser level treatments that will save all of us money .
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mt99
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 5:13 pm

Quoting AGM100 (Reply 65):
I want cost review panels at the federal level. I want to make sure my tax dollars are not being wasted by unnecessary treatments ...tests and other expensive medical proceedures for those that could do without it. I dont think that I should pay for a hip replacement for a 65 year old guy so that he can go play golf and be comfortable at the bridge table. Their should be some level that we have to cut off care or dispence lesser level treatments that will save all of us money .

So you want "Death Panels"? Sarah P would not like you...
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Dreadnought
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 5:23 pm

Quoting mt99 (Reply 66):

So you want "Death Panels"? Sarah P would not like you...

Basically that's what would be required, but the federal government has never shown itself capable of controlling costs on just about anything, so it would be pointless and counterproductive. Knowing the federal government, they would end up (to use AGM's example) blocking a 65 year-old's hip replacement but then turn around and allow a sex change operation.
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mt99
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 5:30 pm

Quoting Dreadnought (Reply 67):
hey would end up (to use AGM's example) blocking a 65 year-old's hip replacement but then turn around and allow a sex change operation.

What you are doing is assuming.. right?
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FlyPNS1
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 5:30 pm

Quoting Dreadnought (Reply 62):
Scholarships have been available for deserving students for ages.

And a good chunk of scholarship money orginates from government. And private scholarship money doesn't even come close to providing enough resources for all that would need it. The GI Bill is another government subsidy. It's a worthwhile one in my opinion, but it has the same cost skewing effect that you complain of.

And everyone who attends a public university is getting a subsidized education as public universities rely on state/federal funding for part of their operations. In fact, one reason education costs have risen so rapidly is that states have cut back the subsidies forcing universities to cover more of their own budget. The universities have simply passed down the cost to students.

Quoting AirStairs (Reply 63):
Under a "single-payer" education system, any rational person would choose to go to his more expensive, prestigious option over his state school, live in the nicest dorms, go on the study abroad trips, take the expensive classes with lab fees, buy new instead of used textbooks, and so on.

Who says that a "single-payer" system would pay for all those things? Note I've never advocated a pure "single-payer" system for education or health care.


Quoting AirStairs (Reply 63):
We must make the insurance companies compete with one another.

But what if they don't want to compete and would rather just merge into mega insurance companies?

Quoting AirStairs (Reply 63):
it is to means-test financial assistance in order to help get people to where they "belong" in the system, while still exposing them proportionally to the costs of their decisions.

I agree, however most conservatives vehemently oppose this.

Quoting AGM100 (Reply 65):
Millions of lower middle class and poor kids have strove to achieve and made it out of their situation.

Yes, and most of them benefited from having their educational expenses subsidized by state/federal government programs.

Quoting AGM100 (Reply 65):
We need a federal review board to decide who gets to go thats all I want.

Do you really want a federal worker deciding if its better to send Johnny to school for his engineering degree or Janie to school for her teaching degree?

Quoting AGM100 (Reply 65):
Their should be some level that we have to cut off care or dispence lesser level treatments that will save all of us money .

I agree, but I believe most conservatives called your idea "death panels."
 
AGM100
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 5:41 pm

Quoting mt99 (Reply 66):
So you want "Death Panels"? Sarah P would not like you...


Yes ... I guess your right. It is only responsible and "just" to the taxpayer community that steps are taken to assure the dollars are spent on reasonable and justified care. A argument used to justify universal health care is that it will create a healthier population who is free to start buisness , work and grow the economy to new heights without care of healthcare costs !. Why should tax dollars go to those who can not participate and join the workers in this great mission for the community ?. The elderly , handicapped and physicaly disadvantaged can not work .... so which federal agency decides who is worthwhile ?

I am serious ... I want the tax dollars rationed out for the maximum good of the collective. Is it worthwhile to treat a smoker ,a chrystal meth or crack user ? I think not .... they are undesireables .
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 6:06 pm

Quoting FlyPNS1 (Reply 69):
And a good chunk of scholarship money orginates from government. And private scholarship money doesn't even come close to providing enough resources for all that would need it. The GI Bill is another government subsidy. It's a worthwhile one in my opinion, but it has the same cost skewing effect that you complain of.

Wrong. Scholarships are generally from companies and wealthy persons. My late grandmother set up a foundation that provides full scholarships to six deserving but poor high school students to go to college every year. I am on the selection board. This is not at all unusual - hundreds of thousands of families have done this sort of thing - the kind of families that liberals hate. They just don't like to call attention to themselves.

Quoting FlyPNS1 (Reply 69):
And everyone who attends a public university is getting a subsidized education as public universities rely on state/federal funding for part of their operations. In fact, one reason education costs have risen so rapidly is that states have cut back the subsidies forcing universities to cover more of their own budget. The universities have simply passed down the cost to students.

I have no problem with that. Every state should have at least one university that receives a reasonable subsidy, as long as it doesn't attempt to unfairly push out all other universities.

Quoting FlyPNS1 (Reply 69):
But what if they don't want to compete and would rather just merge into mega insurance companies?

The only time a monopoly can form is if the government approves of it. In the US, states have been allowed to prevent insurance companies from competing in their states, at the request of the established insurance companies of course. Which is why in a state like Washington, population around 7 million, has only a small handful of insurance companies, whereas Switzerland, with the same population and vigorous competition in the health care field, has over 70 companies.

Quoting FlyPNS1 (Reply 69):
I agree, however most conservatives vehemently oppose this.

Bull. Liberals oppose means-testing. They are like crack dealers - give stuff for free and then you have 'em hooked.

There are helpless people in this world, and there are people who need a temporary hand up. I have no problem with this. We live in a very generous society, and for many years prior to social security, people were still taken care of. Given the prosperity that our nation has enjoyed, I suspect that, even without all of these various government benefits, even more people will be taken care of.

On the other hand, there are a huge number of people out there who are healthy, able to work, and produce nothing because government had provided them with a safety net. Every time that safety net gets larger, the population of these types also gets larger.

That is the problem with the safety net concept. People are not static. They react, to some degree, to the government programs and provisions which are offered them. The more the government gives people for free, the less many people will do for themselves. Safety nets need to be just that - a safety net for those few - 5%, 10% of the population that seriously need help. But when that percentage comes up to 40-50% of the population - a goal clearly declared by Obama and other statist democrats, it is no longer a safety net, but purely a means of getting people addicted to your crack, and telling them 'don't vote for the other guy because he won't give you your fix".

Quoting FlyPNS1 (Reply 69):
Yes, and most of them benefited from having their educational expenses subsidized by state/federal government programs.

Bull. See my response above.
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Ken777
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 6:41 pm

Quoting AirStairs (Reply 63):
That is only true if we continue to allow them to enjoy anti-trust immunity. Selling across state lines is important, but not the whole story. We must make the insurance companies compete with one another.

Selling across state lines is trivial IF you allow states the state's right to set standards. As soon as that happens you stop the dream of selling from the state with the lowest standards - which is what the insurance companies want.

In terms of competition, I believe that everything the insurance companies need has already been settled in terms of splitting up the market under ATI and "reform" in this area will not change unless the insurance companies are required to provide protective disclosure. They disclose all activities they want to be covered under ATI and everything else can be called a violation. THEN we will know the games that have been played (legally) under ATI.

Quoting AirStairs (Reply 63):
Knowing my costs are the same whether I take the pill or not, I gladly accepted. But had I been even marginally accountable for the cost of that pill I would have at least thought about whether it was really worth the cost.

A generic Valium Rx probably costs around $5. Maybe a 30 day supply for $4 at WalMart. So focusing on costs you could have picked up the Rx and been prepared for not only that procedure, but any other you might need for the next 2 years.

In terms of decision making evaluations of costs that particular day, I'll bet you's pay a buck or two to ease the joys of the IV needle.  
Quoting AirStairs (Reply 63):
It is common for insurance companies to pay doctors and hospitals less than 30 cents on the dollar of what is billed.
Quoting AirStairs (Reply 63):
So over the span of decades we get $1,000 toothbrushes.

In the article on the $1,000 toothbrush it was pointed out that a lot of insurance companies will not audit hospital bills under $100,000. They just take their discounts and send the check. Makes it easy for a provider to charge $1,000 for a toothbrush and get away with it.

Quoting AirStairs (Reply 63):
Medicare is happy to underpay on just about anything and pass the cost to doctors and hospitals, who pass it to insurers, who, you guessed it, pass it to customers and their employers.

Medicare actually is more active is avoiding the charges like the $1,000 toothbrush. No way will they simply discount it 30% and pay out $700. Come to think of it, maybe private insurance would not be so expensive if the companies worked a little more effectively.

So if underpayment of overcharges like the $1000 toothbrush unsets providers I'll not worry.

I believe in paying providers a responsible amount for the services provided, but I also believe that we need to get realistic as to what the realistic price really is. All to often it is jacked up by excessive padding (like the toothbrush) and all to often it is increased because of the need to pay for those who cannot pay.

Quoting AirStairs (Reply 63):
If you think large insurance companies have unfair power to set prices, just wait until you start dealing with the government.

$1000 for a toothbrush? Nuf Said?

Quoting AirStairs (Reply 63):
It is not a big secret that Medicare pays out under cost, so unless you want to make the government negotiate payout rates in good faith without using legislative power (not going to happen) or come back to the drawing board in a couple of decades when hospitals can't afford to stay open (been to France lately?), this is simply not a solution.

When politicians on both sides of the aisle continue the game of needing a "Doc Fix" each year Medicare (read politicians) will be screwing providers. So what do we need to do?

1. Doc Fix one more time.
2. Set then then established payments as the base payments.
3. Increase the base payments by the same percentage as lawmakers increase their compensation package.
4. Change the Medicare Tax to actually pay for what is provided.

Quoting AirStairs (Reply 63):
It is much more prudent to let the free market run most of the show

We were there for a very long time and costs kept spiraling out of control. That system failed the patients far more than "government" ever did.

Quoting AirStairs (Reply 63):
with the conditions above that they compete across state lines, emphasize HSAs to increase consumption accountability, and do not enjoy ATI)

And maintain State's Rights in cross border sales to ensure patients are not ripped off. Give tax breaks for contributions to HSAs but at the same time address the issues that push costs up.

Quoting AirStairs (Reply 63):
and have a catastrophic/safety net for those who are impoverished than it is to create these odd incentives and convoluted mandates to prop up a policy that otherwise couldn't stand on its own two feet.

Addressing the catastrophic conditions is important, but one key step in that is early screening and access to care that does not include the ER as "Step 1".

And let's understand that it is not only the "impoverished" that can take major hits from catastrophic medical conditions. And, unless someone has easily moved into the 6 digit HSA account levels that account won't even start to cover the brutal future actual patients and their families face. And it is not just about money.

Quoting AirStairs (Reply 63):
Under a "single-payer" education system, any rational person would choose to go to his more expensive, prestigious option over his state school, live in the nicest dorms, go on the study abroad trips, take the expensive classes with lab fees, buy new instead of used textbooks, and so on. Costs would skyrocket and resources would be completely misallocated. Then the news of the cutbacks would come.

I'm one of those who believe that the country as a whole benefits when education standards are increased. That's why I vote for property tax increases when it supports school bond issues. Same with health care, which is why I vote for property tax increases for the Country Health Department.

And I don't believe that we need to send our kids to the most expensive private school in order to get a decent education. There is no excuse for a state not to have an education system that addresses the state's needs for the future. Jr. Colleges and technical schools for the training in fields that can be covered at that level, up to Medical & Law Schools. And at a cost to students that can be paid for without a lifetime student loan.
 
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 6:45 pm

Quoting FlyPNS1 (Reply 69):
Do you really want a federal worker deciding if its better to send Johnny to school for his engineering degree or Janie to school for her teaching degree?

Yes ... if Johnny has shown signs of unreliablity or being weak minded enough to say skip classes or not perfom up to standard then I dont want to pay for his engineering degree. I would prefer students who fall in line with the criteria put forth by the beurau of eduacation behavioural standards...those and only those .

Quoting FlyPNS1 (Reply 69):
agree, but I believe most conservatives called your idea "death panels."

Well , we all know what the conservatives are ... now dont we?... Frankly if you do not subscribe to our political views , the ones who worked to pass universal healthcare , maybe we should look into that. Is it fair to the supporters of the policy that the conservatives who stood against it... recieve the benefits.... hummmm? Lets look at those red states again ....
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mt99
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 6:56 pm

Quoting AGM100 (Reply 73):

Well , we all know what the conservatives are ... now dont we?... Frankly if you do not subscribe to our political views , the ones who worked to pass universal healthcare , maybe we should look into that. Is it fair to the supporters of the policy that the conservatives who stood against it... recieve the benefits.... hummmm? Lets look at those red states again ....

I know that you are trying to be all cute and stuff - so ill shoot back with something as absurd as you are suggesting..

You are wiling to leave with no medicine a potential math genius in favor of a pot-smoking spoiled brat whose parents can afford health care who is done trashing his third Lexus?
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:07 pm

Quoting Ken777 (Reply 72):
$1000 for a toothbrush? Nuf Said?

We can do better than that.

These two little washers cost a cool $1 million. Paid for by our government. What private company would have paid that?

http://gizmodo.com/290706/these-two-washers-cost-1-million
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:15 pm

Quoting Dreadnought (Reply 75):
Paid for by our government.

They got caught no?
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:22 pm

Quoting mt99 (Reply 76):
They got caught no?

Well after they were paid.
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:29 pm

Quoting Dreadnought (Reply 77):
Quoting mt99 (Reply 76):
They got caught no?

Well after they were paid.

But they were caught..
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:33 pm

Quoting mt99 (Reply 78):
But they were caught..

But the money was paid...  
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:37 pm

Quoting mt99 (Reply 74):
favor of a pot-smoking spoiled brat whose parents can afford health care who is done trashing his third Lexus?

No ... they should be taken from thier parents and re-educated to conform, obviously they are not contributing. If they are getting my money I want them to be ship shape and deserving of the benefits.

Not being cute and stuff .... I will actively work that our politicians demand this accountablity at the federal level.

Quoting Dreadnought (Reply 75):
What private company would have paid that?

One with a government contract .....
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:38 pm

Quoting Dreadnought (Reply 79):
Quoting mt99 (Reply 78):
But they were caught..

But the money was paid...

But they were caught... I fail to see your point.

Has a private company NEVER EVER been charged more that they should?
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 7:57 pm

Quoting Dreadnought (Reply 71):
We live in a very generous society, and for many years prior to social security, people were still taken care of.

Yes, if most of our population would simply drop dead by age 65, you are correct that we wouldn't need social security. It would fix our healthcare cost problem too. But darn it, people seem to want to live longer for whatever reasons.

Quoting Dreadnought (Reply 71):
Bull. See my response above.

Not bull. Anyone who attends a public university is automatically getting a subsidized education. Then, factor in those who have gotten financial support from the GI Bill, government loan programs, government grants/scholarship and state grants/scholarships and you'll find that most people got a subsidized education.

Quoting Dreadnought (Reply 71):
there are a huge number of people out there who are healthy, able to work, and produce nothing because government had provided them with a safety net.

Not really. The overwhelming majority of the population works (or wants to work). Yes, there are some deadbeats and there always will be regardless of what the government does.
 
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 8:00 pm

Quoting mt99 (Reply 81):
But they were caught... I fail to see your point.

If your company got a million dollar invoice for a couple of washers, would you pay the invoice and then try to get the money back (and hope that the money wasn't spent in the meantime), or catch the problem before your money goes out the door?

Call me crazy, but I would prefer not to pay it in the first place. That's kindergarten-level fiscal responsibility.

Quoting mt99 (Reply 81):
Has a private company NEVER EVER been charged more that they should?

By 10%? 50%? Even 100%? Sure. It happens. And we will dispute the invoice, or find another supplier if they don't provide a credit.

But overcharged by 262 million percent, and then actually paying it, as in this case? Only a government can do that.
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 8:14 pm

Quoting FlyPNS1 (Reply 82):

Not bull. Anyone who attends a public university is automatically getting a subsidized education.

Not necessarily. I went to University of Texas at Austin. I don't know if this is still the case today, but back then the State of Texas paid nothing whatsoever to the University - UT was funded by the huge endowment provided for it when the University was created. UT owns millions of acres of land and benefits from grazing rights, farm leases, and oil revenue from the resources beneath their land.

Thanks to that endowment and the wisdom of the Texas founders who wanted a University independent of the state coffers, my tuition back then was only about $450 per semester, as I recall.

Quoting FlyPNS1 (Reply 82):

Not really. The overwhelming majority of the population works (or wants to work). Yes, there are some deadbeats and there always will be regardless of what the government does.

Sorry, but you are denying the existence of human nature. Tax something, and you will get less of it. Subsidize something, and you will get more. Microeconomics 101.

I used to work in Russia, and the favorite saying among Russians back then (this was still in communist times and immediately after) was, "they pretend to pay me, and I pretend to work", which is what happens when you make a job "a right". I knew some Russians who were very hard workers - very conscientious. But most did the minimum they could get away with because they knew that their jobs were very secure and they would get paid regardless. Within a few years that illusion came back to hit them hard.

[Edited 2010-04-07 13:16:43]
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 8:19 pm

Quoting Dreadnought (Reply 83):
But overcharged by 262 million percent, and then actually paying it, as in this case? Only a government can do that.

Genius. Pure genius. I literally LOL'd. Welcome to my Respected Users List.   
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AGM100
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 8:24 pm

Quoting FlyPNS1 (Reply 82):
Not bull. Anyone who attends a public university is automatically getting a subsidized education

You mean the universties that the left is now crying about the costs going up .... so the governemnt pays a big portion of the tuitions and the cost have been climbing though the roof ?   
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mt99
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 8:35 pm

Quoting Dreadnought (Reply 83):
But overcharged by 262 million percent, and then actually paying it, as in this case? Only a government can do that.

As always using big scary numbers but fail to put it in context (ie. $100M cost for Catepillar- run for the hills!!)

What was the total supply contract value? was it $100M.. then $1M would be easier to slip through.. was the govt expecting a $0.19 total supply and then they got charges $1M?

Did they govmt say: Please send me 2 washers? and they got billed $1M for them? or was it part of a larger contract that can make $1M look like peanuts?

I mean.. what are the whole story? That's right it doesn't matter does it. Makes for good Fox Headlines.

[Edited 2010-04-07 13:55:31]
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FlyPNS1
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 9:03 pm

Quoting Dreadnought (Reply 84):
Thanks to that endowment and the wisdom of the Texas founders who wanted a University independent of the state coffers, my tuition back then was only about $450 per semester, as I recall.

But they still subsidized your education using revenue that wasn't yours. They used state assets to help pay for your education. I don't have a problem with this, but it's still a subsidy.

Quoting Dreadnought (Reply 84):
I used to work in Russia, and the favorite saying among Russians back then (this was still in communist times and immediately after) was, "they pretend to pay me, and I pretend to work", which is what happens when you make a job "a right". I knew some Russians who were very hard workers - very conscientious. But most did the minimum they could get away with because they knew that their jobs were very secure and they would get paid regardless.

The thing is that most people don't want to live off the government dole, because frankly it's not a very desirable lifestyle. Whether its social security or welfare, neither provide a particularly great lifestyle as they are only safety net programs. Sure, there are a few bums who will milk the system and try to scrape by on government programs, but most people aspire to more.

Quoting AGM100 (Reply 86):
You mean the universties that the left is now crying about the costs going up .... so the governemnt pays a big portion of the tuitions and the cost have been climbing though the roof ?

As government has cut back funding relative to the number of people wanting to go to college, it's no surprise that costs rise. Like healthcare, education is an expensive proposition. With less government intervention, the free-market will push prices to a point where higher education is mostly a luxury good. This was in fact how higher education was treated a hundred years ago.
 
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 9:38 pm

Quoting FlyPNS1 (Reply 88):
The thing is that most people don't want to live off the government dole, because frankly it's not a very desirable lifestyle. Whether its social security or welfare, neither provide a particularly great lifestyle as they are only safety net programs. Sure, there are a few bums who will milk the system and try to scrape by on government programs, but most people aspire to more.

But most is not enough. I think you are right, but even if it's only 5% of the population that are bums whose only claim to fame is an occasional starring role on COPS, those few percent are very expensive for the rest of us. 1% may be manageable, but it gets bad from there upwards.
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AirStairs
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RE: Health Care Reform Passed (Part 3)

Wed Apr 07, 2010 9:41 pm

Quoting FlyPNS1 (Reply 69):
But what if they don't want to compete and would rather just merge into mega insurance companies?

The Federal Trade Commission has plenty of power to prevent large corporations from merging and enforcing anti-trust laws, so your point is meaningless.

Quoting FlyPNS1 (Reply 69):
I agree, however most conservatives vehemently oppose this.

I don't think they do. I have no problem helping subsidize education because I know that it would reduce the negative externality that I will have to bear by living in a society of uneducated people (and similarly with healthcare), NOT because there are "welfare rights" as judicial nominee Goodwin Liu would have you think. This is a much more limited, pragmatic approach than saying that the services of other people like doctors and teachers belong to you as a matter of morality and right.

Quoting AGM100 (Reply 70):
Yes ... I guess your right. It is only responsible and "just" to the taxpayer community that steps are taken to assure the dollars are spent on reasonable and justified care.

I think this gets to the heart of the problem. If we did have universal healthcare in the way that many propose, we would need death panels of sorts to keep costs down. But the risk of putting life-or-death or even routine healthcare decisions in the hands of the government (which liberals seem convinced is not only efficient but also enlightened and benevolent despite everything we know about history and human nature) is simply far too dangerous.

Quoting Ken777 (Reply 72):
A generic Valium Rx probably costs around $5. Maybe a 30 day supply for $4 at WalMart. So focusing on costs you could have picked up the Rx and been prepared for not only that procedure, but any other you might need for the next 2 years.

In terms of decision making evaluations of costs that particular day, I'll bet you's pay a buck or two to ease the joys of the IV needle.  

Luckily Valium happens to be cheap, but it is the example about incentives that really matters. I have taken new branded drugs that are extremely expensive and may or may not be covered by insurance. When that is the case, I sit down with the doctor and talk about the advantages of taking this more expensive drug, and then decide whether or not the potential benefits are worth the extra cost for me. In some cases, I go for the newer drug, in others, I have opted for a generic. But if everything is fully covered and the insurer (whether public or private) rubber stamps every claim, I will never have to go through this decision-making process, will choose the newer, more expensive medication every time, and the cost of being insured will skyrocket. This is one of the moral hazard problems of insurance.

No one should be exempt from making cost-benefit decisions about their healthcare. Liberals cry foul when it is suggested that people pay a greater proportion of their healthcare. I do not mean greater in absolute terms, but people should face a higher out-of-pocket cost for more expensive drugs and treatments. This will only work if we force providers and insurers to make pricing more transparent, we cannot expect consumers to shop around when they are already in the hospital bed.

Quoting Ken777 (Reply 72):
I believe in paying providers a responsible amount for the services provided, but I also believe that we need to get realistic as to what the realistic price really is. All to often it is jacked up by excessive padding (like the toothbrush) and all to often it is increased because of the need to pay for those who cannot pay.

And what we keep getting back to is the fact that private insurers are essentially subsidizing their public competition (and after Obamacare, their eventual demise). We need to get realistic about price but that is impossible under the current situation and under Obamacare for several reasons. The simple volume of Medicare patients and other factors such as relationships with referring physicians mean that not accepting Medicare patients is a death sentence for hospitals even if they lose money on them. Private insurance companies use monopsony power to negotiate discounts, pushing prices even lower. So hospitals simply inflate list prices and any healthcare professional will tell you that list price is meaningless. It seems that the real solution would be to have Medicare actually pay at cost, but that will never happen when you are dealing with the government. It will only get worse under single-payer.

Quoting Ken777 (Reply 72):
Quoting AirStairs (Reply 63):
If you think large insurance companies have unfair power to set prices, just wait until you start dealing with the government.
$1000 for a toothbrush? Nuf Said?

Yeah and that is WITHOUT legislative power? Think of all the great things the populist progressive movement will do when they take aim at hospitals and doctors for making too much money, and lower the payouts to a more "fair" rate.

Quoting Ken777 (Reply 72):
We were there for a very long time and costs kept spiraling out of control. That system failed the patients far more than "government" ever did.

No we have never had a free market in healthcare. The insurance companies have enjoyed ATI. I am calling for true competition.

Quoting Ken777 (Reply 72):
I'm one of those who believe that the country as a whole benefits when education standards are increased. That's why I vote for property tax increases when it supports school bond issues.

I also believe that the country as a whole benefits when education standards increase, but have voted against almost every property tax increase for schools and certainly voted no this year when our high school district wanted permission to go something like 20% over budget for the next 10 years. I have worked in education with teachers and inner-city schools, and I happen to know that talent and the right training do a hell of a lot more than money when it comes to underserved students. I would rather (and often do) lend my time and money to private nonprofits who have a demonstrated track record of excellence in urban public education improvements than padding public school budgets so they can hand out a union pay increase to avoid a strike.

Did you know it costs over $150,000 to fire a bad teacher in New York State? That something like 7 bad teachers are fired a year in the entire city of New Jersey?

Quoting Ken777 (Reply 72):
And I don't believe that we need to send our kids to the most expensive private school in order to get a decent education. There is no excuse for a state not to have an education system that addresses the state's needs for the future. Jr. Colleges and technical schools for the training in fields that can be covered at that level, up to Medical & Law Schools. And at a cost to students that can be paid for without a lifetime student loan.

Of course I think state schools have done wonders as far as improving quality of life. What I am saying is that we should help the brilliant lower-middle class kid who worked his ass off in high school to get where he wants to go, but if he gets into Princeton and his state school, he should have to give up more to go to Princeton. This pretty much is the case in education, but for some reason people find it immoral in healthcare.

Quoting mt99 (Reply 78):
Quoting Dreadnought (Reply 77):
Quoting mt99 (Reply 76):
They got caught no?

Well after they were paid.

But they were caught..

That they were caught has nothing to do with it. Do you think the DoD civil servants who enjoy the myriad protections of bureaucratic job security got fired over this? Also note that the government was wildly effective in getting $7 million back out of $20.5 million, so well over half of that will never be seen again. And to think the government actually MADE money bailing out Citibank!

Quoting mt99 (Reply 81):
Has a private company NEVER EVER been charged more that they should?

I'm sure plenty have. But investment in poorly run companies is voluntary and comes with a good degree of accountability to stockholders. The idea that politicians are directly accountable to voters is a farce and bureaucrats are even less so.

Funny the apparent unconcern about millions of dollars of waste of direct taxpayer money, yet the outrage when a bank that has actually given taxpayers a return on their investment spends a couple hundred grand on a corporate retreat or a holiday party.

Quoting FlyPNS1 (Reply 82):
But darn it, people seem to want to live longer for whatever reasons.

If they want to or plan on living longer they should be responsible for saving appropriately.

Quoting Dreadnought (Reply 84):
I knew some Russians who were very hard workers - very conscientious.

I have met some as well: interesting that many of the hardworking, conscientious ones emigrated to America.
 
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RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 2:36 am

Quoting AGM100 (Reply 65):
What other country in the world has had millions of poor kids rise to the levels that we have?

Let's start with some European and Asian countries after WW II.

Quoting AGM100 (Reply 65):
See the problem with the lefties running it now is that they do not believe in the American dream .... they just dont understand it.

Strangely enough, I believe that some "lefties" overseas (which would include conservatives as well as liberals) look at the US in this century and have troubles understanding it. We're not talking the "American Dream", we're talking the American Reality in the new century. We've had other times where decent people around the world looked at us and shook their heads - the Ugly American is a classic example.

I believe to simply toss off the "lefties" (as you and Rush call anyone who doesn't agree with you) is short sighted, poorly informed and demeaning to yourself as much as those you wish to put down.

Quoting AGM100 (Reply 65):
I am not saying that some grants and governemnt programs are not warranted ... but a government student loan industry ?

The "governemnt student loan industry" has been around for a long time. But it has also been use as a means of paying out some candy to the banks - which either costs us taxpayers more money, or reduces the funds available to the students.

I really cannot see any reason to pay more to a financial institution for a job that can easily be handled by the government.

Quoting AGM100 (Reply 65):
If they are going to use my money to spread around to treat other people ... I want cost review panels at the federal level.

You have them, but they are cost reviews, ensuring that we don't pay $1,000 for a toothbrush.  
Quoting AGM100 (Reply 65):
I want to make sure my tax dollars are not being wasted by unnecessary treatments ...tests and other expensive medical proceedures for those that could do without it.

And I would like to make sure that ethical doctors can order tests and other procedures for patients, based on their need, not on their financial situation or the ability of their employers to pay for health insurance.

Only In America can we train the brightest to be Doctors at the highest standards possible, then pay a high school graduate sitting at a computer a spiff every time they "decline authorization" of payment for the tests and treatments that the Best & Brightest in America believe are necessary to bloody well PROPERLY CARE for their patients.

I have yet to figure out why we don't just admit only Accounting graduates to med school. It would sure as hell save a lot of effort.

Quoting AGM100 (Reply 65):
I dont think that I should pay for a hip replacement for a 65 year old guy so that he can go play golf and be comfortable at the bridge table.

You don't.

You pay for a person needing a hip replacement because it gets them out of continual pain. It helps keep them from being bed-ridden (which would cost a hell of a lot more than the surgery) and, to some degree, allows them to be more productive in their old age. The next time some elderly volunteer at the hospital helps you or a family member you might try to figure out if they've got original or new hips.  
Quoting FlyPNS1 (Reply 69):
Do you really want a federal worker deciding if its better to send Johnny to school for his engineering degree or Janie to school for her teaching degree?

To some degree that is already going on if either or both are heading to a state school. They are called the Admissions Committee, but they generally try to fit in a "balanced" group of students. If everyone was studying engineering or nursing then there would be a lot profs in other fields that would be out of work.  

I do, however, tend to believe that we can benefit from "motivations" to increase students in areas like nursing where continuing needs will increase. Those motivations could be reductions in student loans when graduates work in government or non-profit facilities. Additional "incentives" for working in under served areas. I believe that we all benefit from that in the long run.

Quoting AGM100 (Reply 70):
It is only responsible and "just" to the taxpayer community that steps are taken to assure the dollars are spent on reasonable and justified care.

And it is only responsible and morally justified when decisions are based on the ethics of the profession, and not the anger of taxpayers - who may well benefit from said ethics in the future.

Quoting AGM100 (Reply 70):
The elderly , handicapped and physicaly disadvantaged can not work

The elderly are not necessarily dumb or non-productive. And having a person end up in a wheel chair does not mean that they have had a half their brain removed.

As for the handicapped like downs, it has been shown that many are actually better workers in "boring, repetitive" jobs than the bright ones that turn their noses up at the handicapped and the jobs.

Quoting AGM100 (Reply 70):
Is it worthwhile to treat a smoker ,a chrystal meth or crack user ? I think not .... they are undesireables .

Let's put the smoker in the same group as those who drink. Booze & cigs do cost us a lot of money - but they also bring in a lot of tax dollars. So let's simply set the tax rates for Booze and tobacco at the rate needed to care for those who end up with problems. And lets add in the damages done by drunk drivers to that tax - keeps you and me from having to pay for it.

And WTF, problems related to diabetes costs this country a fortune each year. You and I shouldn't have our taxes or insurance raised, so let's bring on that tax for soft drinks and pastries, etc. DingDong should bring in at least 25
 
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DocLightning
Posts: 21773
Joined: Wed Nov 16, 2005 8:51 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 4:20 pm

Quoting AGM100 (Reply 15):
Dont know if this is related ..but my Girl friend who is a heart specialist at a hostpital here in Tucson was notified that they are cutting the work force by 20% over the next 18 months. A 15% cut will be made fiscal 2010 with a 20% by 2011. Seems weird to me . The employees are blaming the cuts in Medicare / Medicaid reimbursment rates , basicaly they cant not make a profit.

Yup. This is why any allusions to healthcare being a "free market" are wrong. There are too many things that are out of the control of consumers.

Congress needs to decide whether Medicare should exist or not. The pay cuts make it essentially a money sink because money is put into it, but never taken out because nobody wants to take Medicare/Medicaid patients anymore.
-Doc Lightning-

"The sky calls to us. If we do not destroy ourselves, we will one day venture to the stars."
-Carl Sagan
 
dxing
Posts: 5859
Joined: Wed Nov 12, 2008 5:14 pm

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 4:37 pm

Quoting mt99 (Reply 87):
Did they govmt say: Please send me 2 washers? and they got billed $1M for them? or was it part of a larger contract that can make $1M look like peanuts?

I take it you never look at your grocery reciept to see if there were any errors made, you just assume that the total is correct if it falls within your mental ballpark of what you think you spent? Same with your credit card invoice? Car repair? No matter how big the bill is, if it is itemized it pays to look it over before you pay the bill. Much easier to get an error corrected before the money is paid. Unfortunately when we are talking government money, "well hell, it's somebody elses any way so what's the big deal" seems to be the general attitude and it is usually some reporter who stumbles across mistakes like this.
Warm winds blowing, heating blue skies, a road that goes forever, I'm going to Texas!
 
AGM100
Posts: 5077
Joined: Thu Dec 04, 2003 2:16 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 4:42 pm

Quoting Ken777 (Reply 91):
Let's start with some European and Asian countries after WW II.

Sorry , Ken .... I was just trying to credit the US with something done well.... I forgot we are supposed to be down on everything.. make a crisis of everything for that fundamantal change. Check it ... we have 28 of the top 50 Universities in the world and by far the most number of graduates .

Funny , I was just with the admissions department and watched the ladies eye's grow when I said "we do not want Governemnt funds" for my daughters education. I saved I worked and so did she to afford it ! She told us , well apply anyway because hey it is open too you .... I said no thanks . She probably had not seen someone like me in a long long time.

Quoting Ken777 (Reply 91):
You and I shouldn't have our taxes or insurance raised, so let's bring on that tax for soft drinks and pastries, etc. DingDong should bring in at least 25

Of course ... Ding Dongs will not go to $25 they will be out of existence which frankly is the goal of the left wing. They want unemployment to keep rising ... its more dependents for them... they would prefer Hostess be gone and replaced with the
" Federal Snack Company" yummmm.
You dig the hole .. I fill the hole . 100% employment !
 
mt99
Posts: 6166
Joined: Wed May 26, 1999 5:41 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 4:44 pm

Quoting DXing (Reply 93):
I take it you never look at your grocery reciept to see if there were any errors made, you just assume that the total is correct if it falls within your mental ballpark of what you think you spent? Same with your credit card invoice? Car repair?

Well if i paid $200 in groceries and there is a $1 item on a list of 50 items.. i wouldn't take a second look. Does that make it right? Absolutely not - but you guy love to inflate the scale of things for no useful purpose.

Quoting DXing (Reply 93):
No matter how big the bill is, if it is itemized it pays to look it over before you pay the bill. Much easier to get an error corrected before the money is paid.

So wait, you ask to see the itemizes receipt in the grocery store before you pay?. Remind me never to wait in line after you.
Step into my office, baby
 
dxing
Posts: 5859
Joined: Wed Nov 12, 2008 5:14 pm

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 4:54 pm

Quoting mt99 (Reply 95):
Well if i paid $200 in groceries and there is a $1 item on a list of 50 items.. i wouldn't take a second look. Does that make it right? Absolutely not

But somehow it's ok for the government to ignore it simply because there are more zero's involved?

Quoting mt99 (Reply 95):
So wait, you ask to see the itemizes receipt in the grocery store before you pay?. Remind me never to wait in line after you.

I watch the price as it is rung up and stop the cashier if I think the price is wrong. I also double check the register reciept after my purchase is made. You bet I check the bag to make sure all the food I ordered at the take out window is in there before I pull away. You bet I ask for an itemized list of charges before I pay for eye glasses, auto repair, or any number of other things.

Quoting mt99 (Reply 95):
Remind me never to wait in line after you.

If you're not concerned about watching your money then yeah, you need to find a different line. Lately I've taken to using the self check out line to eliminate the variable of the clerk. The only time I use the clerk now is if I have an object to big to slide over the self check out scanner.
Warm winds blowing, heating blue skies, a road that goes forever, I'm going to Texas!
 
AGM100
Posts: 5077
Joined: Thu Dec 04, 2003 2:16 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 5:16 pm

Quoting DocLightning (Reply 92):
Congress needs to decide whether Medicare should exist or not. The pay cuts make it essentially a money sink because money is put into it, but never taken out because nobody wants to take Medicare/Medicaid patients anymore.

 Wow! Doc what they want is one big giant Medicare correct ? Isnt that what universal healthcare is ? . What they are trying to do now is just kill off the competion to medicare and medicaid .... they want the insurance companies gone so that we do not have a choice . I assume that is what you want as well .... correct.?

I have argued this point in the past ..that we need to go one way or the other ... freemarket choices and governemnt programs do not mix .
You dig the hole .. I fill the hole . 100% employment !
 
mt99
Posts: 6166
Joined: Wed May 26, 1999 5:41 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 6:06 pm

Quoting DXing (Reply 96):

But somehow it's ok for the government to ignore it simply because there are more zero's involved?

I never said it should be ignored. My point is that you make the fact that 1/200th of the total cost something is a HUGE deal. I never said it was right. You fail to see the perspective. Miss the forest for because of the trees.

Quoting DXing (Reply 96):
I think the price is wrong

Ahhh - so you commit to memory all prices in the store!. I knew you were smart, but man..

Quoting DXing (Reply 96):
Lately I've taken to using the self check out line to eliminate the variable of the clerk

Thats right buddy - better keep moving - everyone's after you including Safeway  
Quoting AGM100 (Reply 94):
was just with the admissions department and watched the ladies eye's grow when I said "we do not want Governemnt funds" for my daughters education. I saved I worked and so did she to afford it ! She told us , well apply anyway because hey it is open too you .... I said no thanks . She probably had not seen someone like me in a long long time.

Which is fine. You are free to do as you please, but you are willingly making things more expensive to yourself to prove a point?
Step into my office, baby
 
AGM100
Posts: 5077
Joined: Thu Dec 04, 2003 2:16 am

RE: Health Care Reform Passed (Part 3)

Thu Apr 08, 2010 6:53 pm

Quoting mt99 (Reply 98):
Which is fine. You are free to do as you please, but you are willingly making things more expensive to yourself to prove a point?

No ...the price is the same they just want me to loan it from the G . They are actively "selling loans" from the government. Our government is now a bank .... WTF is that ? Sorry the founders never intended the federal governemnt to become a bank.

And what Obama did was just cut the banks out of the buisness so the G could be the only source for loans .... its Mafia style.
You dig the hole .. I fill the hole . 100% employment !

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