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Obamacare: Say goodnight, Gracie...
- Thread starter miguel
- Start date
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They not only did it by themselves, they had to resort to parliamentary tricks to get it through congress and thwart the will of the people.
What is the will of the people now? They like the parts of Obamacare which drive costs most. The overton window has shifted far enough that a clean repeat is not politically possible through normal legislative process. Short of resorting to parliamentary tricks themselves, it's doubtful they could get that through congress. In a society of hundreds of millions of people, with widely varying wants and needs, you take what you can get politically. You stay in the window.
But I do think Republicans could have gotten more than they're trying to get. I think they could have gotten something closer to Rand Paul's plan.
I was afraid that this kind of crap was going to happen!
The elected republicans are cowards, almost all of them. They need to simply repeal the ACA as of some date a few years in the future, that way insurance companies, businesses, and individuals citizens can have a few years to plan for the return to normal. But OH NO! They have to think that because the liberal idiots did something big they have have to as well. That just makes them conservative idiots.
Then they want to keep the mandate for preexisting conditions in place, because, well... that is nice and they would be mean if they don't. But then they don't want to force people to buy the insurance. Look I agree with the second part 100%, but the problem is that if you force the insurance industry to take on massive losses (ie. people with preexisting conditions) then you need to balance that in some way, otherwise the system will collapse.
This is like people not having home owners insurance but being allowed to buy a policy a day after the house burns down and forcing the insurance company to pay for it. Does the word "stupid" fit in this thought process?
If we're going to force insurance companies to cover people with preexisting conditions I could discuss a thought like this:
#1) Insurance companies cannot refuse anyone under the age of 28;
#2) IF a person under 28 has a preexisting condition the company may charge them more, up to 20%, on their premium, but still covers them;
Note: Actuarial s would have to discuss this ^^^ a bit, I'm just giving a start off point.
#3) AFTER someone turns 29 then the insurance companies are free to decline someone coverage based upon a preexisting condition;
#4) Should someone have a claim after the age of 28 then;
A) Hospitals are NOT required to engage in heroic measures to save that persons life, and;
B) IF they DO, then the hospital must put that on their books AFTER calculating their costs - in other words, the hospitals may not pass heroic costs onto the insurance industry and/or individual persons;
#5) If a person does not have coverage and they suffer a loss then they become 100% liable for all costs of the treatment and may not declare medical bankruptcy until they are truly penniless;
#6) If a person does not have coverage and they suffer a loss then they and their children are automatically disqualified from any government assistance of any kind, no matter what!
#7) Someone who needs constant medical care, like a coma patient, who isn't dying, would need special rules, possibly tax breaks for the insurance companies, limits on coverage, etc. (I don't know, but this burden is massive)
#8) There would need to be some time to phase this in, not too short or too long. Perhaps over a decade for folks to get comfortable to the idea that individual responsibility will be coming.
Basically, all of the above is designed for me to compromise on allowing preexisting conditions - TO A POINT. However, it also puts massive pressure on people to get coverage so that they are not facing financial ruin. The threat doesn't come externally from the government taxing/fining them. Rather it comes internally, from the fear of ruination by failing to be personally responsible. It would give them an out to a certain age, but after that it is on them to step up or possibly be stepped on.
On the other side of the coin we would have to force the free market onto the health care industry by compelling health care providers to publish their costs on everything. Then, force insurance companies to pay for any treatment a policy holder finds cheaper somewhere else AND pay the policy holder the difference. The government would incentivize this by saying that any monies made by the policy holder are tax free and do not jeopardize and government assistance. In this way the insurance company neither wins nor loses, the policy holder wins by shopping, and the health care provider loses huge by failing to offer competitive costs. So say that I need a new hip and my local hospital is going to charge, for everything, after the negotiated price, $75k. If I go online and find a surgical center in Oklahoma that will do it for $15k, then the insurance company pays $15k to the health care provider, and I get to keep $60k in pure profit for that year. I win, the insurance company neither wins nor loses (they were out $75k no matter what), and the local hospital loses my business. I guess they'll learn to compete like every other business or die on the vine of free market capitalism. That is a threat they do not face today.
To finally get back on point the problem now is that the republicans are going to argue among themselves and either do nothing OR just slightly water down the current ACA because they are afraid of making some people mad. They voted a helluva lot to repeal it when there was no hope of success, but with success now in hand the cowards can't have one vote, just one? Cowards!
Regards,
Doug
The misconception embodied in this post is that cheaper is better. Would you select someone to remodel your house solely on the basis of the lowest bid? Would you select a bodyshop to repair your accident damaged car solely because they submitted the cheapest bid? Do you choose your dentist based on his/her prices being the lowest? And these are areas where to a greater or lesser extent you can still live your life while suing if the work is substandard
Would you really select your surgeon for that hip replacement or heart valve work or any serious condition based solely on them having the cheapest price? Because you could do an awful lot of suffering , or even some dying, while waiting for judicial relief. The government and/or insurance companies should have been collecting data on quality and success rate of provided care for ten years before trying to implement a system like yours, with a penalty system that aggressively weeds out bad or careless providers.
The whole health care system has skewed incentives at every turn. It needs a drastic overhaul but this ain't it. I do however strongly agree with repeal first, setting a hard future date such as 2020 for taking effect. A looming deadline like that should help concentrate the minds of all involved (at least those that actually pay for things) to come up with a plan
I think you may have misunderstood my post. Cheaper is not necessarily better. However, overpriced and bloated medical costs do not reflect better care either.
The fact is that when https://surgerycenterok.com/ can offer the same surgeries with the same doctors as the nearby Baptist Medical Center for about 10% of the price, then the issue medical pricing does come into play, significantly. European costs for treatment are significantly less than ours. This is top rated care. NPR ran a story about a person going Belgium for a hip replacement and paid the entire amount out of their own pocket, about $20k for everything while in their home state of New Jersey it would have been over $90k. Of course, the Belgian hospital didn't have a Starbucks or a 10,000 gallon fish tank or plasma TV's on the wall. It just had top of the line medical equipment and trained staff. It was designed frugally for efficiency and not bloated costs.
You seem to be confusing expensive with high quality. This is sometimes true, like with a Rolls Royce car v/s a Hyundai. But even then does the cost justify the expense? Perhaps... But with medical care it is different. You ask what would I chose. Here is the answer. IF the doctors had the same accreditation, the same education, extremely similar facilities, and similar recovery rates? Easy. Then I would easily chose the less expensive one as this would be the economically and morally superior choice. As funds are limited for health care any money I save my insurance company could be spent on helping someone else without burdening the remaining policy holders with higher premiums the next year. Even if it was just myself I would rather save the money and have it to spend on other needs or services than going down the sinkhole of bloated medical expenses.
I am not talking "substandard" work. I am not attacking the doctors, nurses, or medical staff that actually provides care. I am attacking the bloated medical bureaucracy that confuses and obfuscates and lies in order to justify expenses that don't need to be. Or, in the case of "nonprofit" hospitals to justify their nonprofit status by constantly growing and spending money on crap we don't need.
Some of these costs do come from government rules and regulations and those should be removed, but they're overused as an excuse by the medical industry.
Whatever incentives there need to be must come organically, from within. I don't want to force anyone into a direction except that of getting as close to competition and a free market with health care as we can. And right now that must be forced onto the medical industry. By truly forcing them to compete in a free market as most other industries do their reforms will originate organically and internally, which is what I believe most Americans believe in. Compete and innovate or stagnate and die.
Here is a little story on what happens when companies are not truly forced to compete, ala Warsaw, Indiana: http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?pagewanted=all&_r=0
In any other industry like electronics prices drop. Not so in the medical prosthetics industry. Here, even though designs haven't changed significantly and orders have increased massively so too have the prices! Why? Because no one is forced to compete. When these companies are not forced to compete they don't truly conspire or collude, but when everyone knows what is being charged for a new knee and profits are massive for everyone, why should they drop their prices? Why not just keep gouging? 'Cause that's what they do! It wouldn't be so bad if the government didn't put significant barriers to entry on foreign manufacturers and local startups, but they do.
Am I 100% right? Of course not! There are vast areas of the health care system that we haven't really touched on and I know I haven't. But I do believe strongly that capitalism and the free market are a damned good place to start. By forcing competition and the free market prices will fall, perhaps significantly. Then access to medical care won't be so burdensome on people, which will give greater access to a greater number of people.
Regards,
Doug
Are you 100% correct? Unlikely, but I find I agree with most of what you say on the matter.
I'd also like to see us stop chasing the dragon with us older folks. If you have bad knees at 65, give them a wheelchair and make sure Wal-Mart has ramp access. Earn those blue handicap medallions for a change!
We spend too much money on folks in the last year or two of life. It's time to recognize that grandma doesn't get heart valve replacements at 85.
I'd also like to see us stop chasing the dragon with us older folks. If you have bad knees at 65, give them a wheelchair and make sure Wal-Mart has ramp access. Earn those blue handicap medallions for a change!
We spend too much money on folks in the last year or two of life. It's time to recognize that grandma doesn't get heart valve replacements at 85.
I am certainly in agreement with the overall idea, my point was the infrastructure to make it workable does not exist; and this being America (and the AMA and AHA as well as other deep pockets lobbying groups being what they are), it would be difficult to compel the healthcare industry to provide it. If you create a new government bureaucracy to collect and disseminate the relevant data then you've just shot the wad on most of your savings. The lack of transparency has to be dealt with before or simultaneously with the reforms you propose. And I think you need to free hospitals from the requirement to treat anyone who can make it through the doors of the emergency room, regardless of ability to pay, if you wish to put real pressure on relatively healthy people to carry health insurance
Research The Cleveland Clinic and the clinic model of medicine for one idea to control costs (that Drs wont like) but again, you can't force the change and it takes time for a superior system to win out through market forces
Research The Cleveland Clinic and the clinic model of medicine for one idea to control costs (that Drs wont like) but again, you can't force the change and it takes time for a superior system to win out through market forces
I was afraid that this kind of crap was going to happen!
The elected republicans are cowards, almost all of them. They need to simply repeal the ACA as of some date a few years in the future, that way insurance companies, businesses, and individuals citizens can have a few years to plan for the return to normal. But OH NO! They have to think that because the liberal idiots did something big they have have to as well. That just makes them conservative idiots.
Then they want to keep the mandate for preexisting conditions in place, because, well... that is nice and they would be mean if they don't. But then they don't want to force people to buy the insurance. Look I agree with the second part 100%, but the problem is that if you force the insurance industry to take on massive losses (ie. people with preexisting conditions) then you need to balance that in some way, otherwise the system will collapse.
This is like people not having home owners insurance but being allowed to buy a policy a day after the house burns down and forcing the insurance company to pay for it. Does the word "stupid" fit in this thought process?
If we're going to force insurance companies to cover people with preexisting conditions I could discuss a thought like this:
#1) Insurance companies cannot refuse anyone under the age of 28;
#2) IF a person under 28 has a preexisting condition the company may charge them more, up to 20%, on their premium, but still covers them;
Note: Actuarial s would have to discuss this ^^^ a bit, I'm just giving a start off point.
#3) AFTER someone turns 29 then the insurance companies are free to decline someone coverage based upon a preexisting condition;
#4) Should someone have a claim after the age of 28 then;
A) Hospitals are NOT required to engage in heroic measures to save that persons life, and;
B) IF they DO, then the hospital must put that on their books AFTER calculating their costs - in other words, the hospitals may not pass heroic costs onto the insurance industry and/or individual persons;
#5) If a person does not have coverage and they suffer a loss then they become 100% liable for all costs of the treatment and may not declare medical bankruptcy until they are truly penniless;
#6) If a person does not have coverage and they suffer a loss then they and their children are automatically disqualified from any government assistance of any kind, no matter what!
#7) Someone who needs constant medical care, like a coma patient, who isn't dying, would need special rules, possibly tax breaks for the insurance companies, limits on coverage, etc. (I don't know, but this burden is massive)
#8) There would need to be some time to phase this in, not too short or too long. Perhaps over a decade for folks to get comfortable to the idea that individual responsibility will be coming.
Basically, all of the above is designed for me to compromise on allowing preexisting conditions - TO A POINT. However, it also puts massive pressure on people to get coverage so that they are not facing financial ruin. The threat doesn't come externally from the government taxing/fining them. Rather it comes internally, from the fear of ruination by failing to be personally responsible. It would give them an out to a certain age, but after that it is on them to step up or possibly be stepped on.
On the other side of the coin we would have to force the free market onto the health care industry by compelling health care providers to publish their costs on everything. Then, force insurance companies to pay for any treatment a policy holder finds cheaper somewhere else AND pay the policy holder the difference. The government would incentivize this by saying that any monies made by the policy holder are tax free and do not jeopardize and government assistance. In this way the insurance company neither wins nor loses, the policy holder wins by shopping, and the health care provider loses huge by failing to offer competitive costs. So say that I need a new hip and my local hospital is going to charge, for everything, after the negotiated price, $75k. If I go online and find a surgical center in Oklahoma that will do it for $15k, then the insurance company pays $15k to the health care provider, and I get to keep $60k in pure profit for that year. I win, the insurance company neither wins nor loses (they were out $75k no matter what), and the local hospital loses my business. I guess they'll learn to compete like every other business or die on the vine of free market capitalism. That is a threat they do not face today.
To finally get back on point the problem now is that the republicans are going to argue among themselves and either do nothing OR just slightly water down the current ACA because they are afraid of making some people mad. They voted a helluva lot to repeal it when there was no hope of success, but with success now in hand the cowards can't have one vote, just one? Cowards!
Regards,
Doug
I feel like you're missing a major spot where money is taken from your pocket and flushed down the drain.
After watching my father be placed in a hospital room for 9 hours and then discharged after a doctor saw him for 3 minutes, charging medicare $23,000, I have to say some of the blame belongs on the hospitals themselves. Defrauding medicare should carry consequences, and instances like this should be swiftly audited.
I can't imagine how many times a day this happens and to what extent it happens. All those tax dollars being flushed down the drain. These are the types of reasons why we could never have a viable single payer system in this country. People don't care about the country, they only care about how much they can exploit out of it.
I hear ya!
The first part of my rant was regarding what is spoken of in the media mostly, not on INGO. The idea that preexisting conditions MUST be covered all the time by everyone. I was merely giving an idea of how I may(?) be willing to compromise.
But you hit the nail on the head which is where the bulk of my ranting and b****ing is usually directed - overpriced and bloated costs from the medical industry!
The medical industry almost always gets a free pass by everyone because our doctors and nurses and techs are nice, friendly folks whom we love, especially when we are sick and they make us better. People have a difficult time differentiating between their "doctor" and the medical "industry" that pays him/her. It is the same for me when I attack the republican party. I am almost always directing my frustration and the official party (which is mostly stupid like NOT getting rid of the ACA) and the general republican on the street (who is mostly reasonable and wants real fiscal responsibility.)
I haven't even discussed the pharmaceutical industry much. There is another portion of the health care industry that could use some review - at least part of it. I have a friend who hasn't been able to get rid of her shingles. This is horrible! She is in constant pain and although it has reduced over the last nine (9) monthes it hasn't gone away. One prescription they put her on was a little over $500 / month! How many people could afford $6k / year for one (1) prescription? Not many. She had such a bad reaction to it that she dropped it, but at least she was able to afford it and try.
On the other hand I just refilled two (2) of my hypertension prescriptions. Both of mine generic through Walgreens. My new doctor gave me a prescription for a year and I filled them for a year (technically 360 days.) Both prescriptions ran $10 / month or $120 total for the year. To me that is a reasonable price. Heck, that is even "cheap!" I could see many prescriptions costing more than $5/month but $500? And of course some scipts can run into the thousands of dollars per month. 99% of all Americans could not afford that yet that is the bill. I would like to see that truly justified, and by that I mean allowing independent accountants review their costs. Of course that will never happen.
President Obama was 100% correct on identifying the problem of health care costs. He was 100% WRONG on how he tried to correct that problem.
The smallest, easiest step I could see through legislation that I believe would be reasonable is to pass a federal law mandating that all health care providers provide an itemized list of costs for services. We currently have this with our food labeling. By law food products must inform us as to the contents of the food. Why not make such a simple thing with health care? We could, and they would stomp and scream and gnash their teeth, but they could be forced to do this.
The other big problem we face that can never be solved is how we view health care philosophically. Do we all expect heroic attempts to save a life? Do we all agree on what should be done if a loved one who is in a coma has another heart attack, after the four (4) before the next one? Do we spend hundreds of thousands of dollars on a baby that is born with an illness that will almost certainly kill it before it turns one year olde? These questions and many like them can never be agreed upon, and that simply adds another level of complication to an already deep and complicated topic.
Regards,
Doug
Doug, I agree with most of what you're saying, however, I cannot disagree with this strongly enough. President Obama was maybe as much as 10% correct on identifying the problem of health care costs. The problem Obama solved, is the problem where not enough people have health insurance. The idea was that since uninsured people end up getting treatment anyway through emergency rooms, that cost is spread across the population that are insured, making the price they pay higher. But uninsured people isn't why my colonoscopy was so expensive. I didn't go to the emergency room for that. I went to a medical group which doesn't treat uninsured people.
If uninsured people are the biggest drivers of healthcare costs, then healthcare should have been prohibitively expensive in the 60s and before, when far fewer people had health insurance.
My parents weren't rich. My dad worked two Jobs. My mom was a nurse. They got by okay. They paid for my and my 3 siblings' birth out of pocket. It was much more affordable to the average person back then. It had to be, because people had to make their own decisions. Costs in a free market are generally at least limited by what people can afford to pay.
If anything, insurance, at least the crony way it works in the US, is the biggest driver of healthcare cost. I'm not against private insurers, but the way we do it has taken much of the decision making away from the people who benefit most from lower healthcare cost. There's no incentive to drive the cost of healthcare down. We go to the doctor. We maybe pay a co-pay. The Doctor's office files the claim. We get a bill for what the insurance doesn't cover. We can't demand lower prices by taking our business elsewhere. The costs are generally the same for most providers because what they charge is negotiated by all the same insurers. We're taken out of the loop. The only pressure on cost is insurance companies trying to get a better bottom line, which they can also do by raising their premiums.
The current healthcare system, from top to bottom, including the insurance companies, is designed to extract the most money from the most people. And forcing everyone to purchase insurance is not the solution to the actual problem we have. If anything it makes costs worse because 1) we force insurance companies to absorb the cost of paying out preexisting conditions. 2) when people HAVE to have insurance by law, insurance companies have less incentive to pressure health care providers on cost to improve the bottom line, because people, by law, have to pay what they charge in premiums. So just raise them more.
I would completely repeal Obamacare. Require that doctor offices not even ask if people have insurance. Run a credit check if they're afraid they won't pay. Just advertise services and prices. People pick and chose. They get their bill when services are rendered satisfactorily, the patient files the insurance claims, get their payoff, and then pay the doctor. For people who truly can't afford healthcare, okay, I'll agree to the safety net. But it's just a safety net. They get medicaid. And it ain't fancy. If you can afford health insurance but you choose not to, well you pay for what you need. If you can't afford it, you made your choice.
If you have a preexisting condition which makes health insurance prohibitively expensive, I think that would qualify for non-fancy medicaid.
All that would be painful as health care providers learn that they must now actually care about cost, and be competitive with the medical group down the street. Three of the four people I had to talk to just to schedule an appointment for a colonoscopy will likely get fired because the butt doctors will need to be competitive on cost.
Well, let's just assume that a businessman is free to employ his cousins, aunt, grandma and anyone else he wants....provided you are willing to pay "X" for the procedure.
So, what was "X"? I know that I paid about $1100 (cash) for a colonoscopy in Florida a number of years back. That didn't seem unreasonable to me, what with the cost of tools, bricks and mortar, good drugs (:0) and an assistant.
So, what did you pay?
By the way, while I had the ability to shop around on a cost basis, what I did was look for the BEST doctor I could find. And that was both his personal and professional reputation.
I still go back to this guy for any plumbing issues. Price is important, but when you have someone crawling around down there, trust is higher in the decision making cue.
So, what was "X"? I know that I paid about $1100 (cash) for a colonoscopy in Florida a number of years back. That didn't seem unreasonable to me, what with the cost of tools, bricks and mortar, good drugs (:0) and an assistant.
So, what did you pay?
By the way, while I had the ability to shop around on a cost basis, what I did was look for the BEST doctor I could find. And that was both his personal and professional reputation.
I still go back to this guy for any plumbing issues. Price is important, but when you have someone crawling around down there, trust is higher in the decision making cue.
Man, you covered a LOT of ground here. I'll give a few thoughts on your comments.
"I agree with most of what you're saying, however, I cannot disagree with this strongly enough. President Obama was maybe as much as 10% correct on identifying the problem of health care costs. The problem Obama solved, is the problem where not enough people have health insurance. The idea was that since uninsured people end up getting treatment anyway through emergency rooms, that cost is spread across the population that are insured, making the price they pay higher. But uninsured people isn't why my colonoscopy was so expensive. I didn't go to the emergency room for that. I went to a medical group which doesn't treat uninsured people."
I didn't state my comment as well as I normally do. In general, I believe that at the time President Obama was 100% correct about assessing severe problems with the healthcare system that the republican party was failing to acknowledge. The republicans were sticking their heads in the sand hoping the problems would go away instead of dealing with them, while Pres Obama identified a major problem within the United States, that of our skyrocketing healthcare costs, access, etc.
The ACA partly addressed the problem of the uninsured. What it did not do is promote any cost reductions that would have helped the system.
I was watching a CSPAN presentation that quoted a study in Massachusetts that shows, CONTRARY TO POPULAR OPINION, that the uninsured do NOT add to the cost of the healthcare system because they wind up paying MORE than insured people do. According to this study 25% of the uninsured don't pay their bills. This is a problem. However, it is counterbalanced by the fact that 66% of the uninsured actually pay more than insured because they simply set up payment plans and cannot negotiate their bills down, as insurance companies do for their clients.
"If uninsured people are the biggest drivers of healthcare costs, then healthcare should have been prohibitively expensive in the 60s and before, when far fewer people had health insurance."
As I do not agree that the uninsured necessarily drive health care costs, I'll go to the second part of this. Part of the issue is technology. The X-Ray machine was invented in 1895! It's basic technology hasn't changed much in over 100 years. During the 1960's and before this was the best technology to look inside the human body. It was 1977 when the MRI was invented. It was 1972 when we had CT scans come out. Before the 1970's our expectations of treatment were minimal. We didn't have all the fancy crap we do now. We didn't have to PAY for all the fancy crap we do now. Today, every health care provider has an MRI machine, which means that every healthcare provider has paid for it and must charge us all for it even if we don't use it. Our advances should have reduced the cost, but they haven't overall.
Look at Laser surgery for eyes. This is an area of healthcare that has actually been forced to operate in the free market and guess what? They have always shown their pricing and reduced costs in order to compete. Even as the lasers have improved the costs have come down for the services received. Why haven't colonoscopy tests come down?
"My parents weren't rich. My dad worked two Jobs. My mom was a nurse. They got by okay. They paid for my and my 3 siblings' birth out of pocket. It was much more affordable to the average person back then. It had to be, because people had to make their own decisions. Costs in a free market are generally at least limited by what people can afford to pay."
Neither were my folks. My father was forced to play in a band on weekends to make ends meet. I think my birth was around $50 at Parkview in Fort Wayne in 1965. They had insurance but it didn't pay much, if anything. My sister was around $25 in 1970. Don't ask me why the price went down, I have no idea.
My doctor told me one time while visiting her, "I just love your (medical) records." I asked what she meant and she flipped back through my chart to a time that I went to the doctor in the late 60's to early 70's. The doctor had written during one of my childhood visits, "Sick. Gave medicine." That was it. Three (3) words. I wonder how long that took to write? I wonder how easy it would be for a doctor to do that today?
"If anything, insurance, at least the crony way it works in the US, is the biggest driver of healthcare cost. I'm not against private insurers, but the way we do it has taken much of the decision making away from the people who benefit most from lower healthcare cost. There's no incentive to drive the cost of healthcare down. We go to the doctor. We maybe pay a co-pay. The Doctor's office files the claim. We get a bill for what the insurance doesn't cover. We can't demand lower prices by taking our business elsewhere. The costs are generally the same for most providers because what they charge is negotiated by all the same insurers. We're taken out of the loop. The only pressure on cost is insurance companies trying to get a better bottom line, which they can also do by raising their premiums."
I don't think insurance is the biggest driver, I still blame the healthcare industry. What I do agree with is that insurance doesn't truly embrace lower costs. If that were the case, insurance companies would be pushing patients to seek treatment through medical tourism and other free market approaches that they just don't do. Yet their profits are not significant. Go to the local library and look for (Forbes or Fortune Magazine, I cannot remember which.) One of these has an annual report on all of the industries in the United States from retail to banking. You will see that the health insurance industry only makes a few percent profit every year. Then look at pharmaceuticals. You can't really look at hospitals because too many of them push for nonprofit status. But you'll see it isn't the health insurance companies getting rich. I do agree they don't fight hard any more.
"I would completely repeal Obamacare. Require that doctor offices not even ask if people have insurance. Run a credit check if they're afraid they won't pay. Just advertise services and prices. People pick and chose. They get their bill when services are rendered satisfactorily, the patient files the insurance claims, get their payoff, and then pay the doctor. For people who truly can't afford healthcare, okay, I'll agree to the safety net. But it's just a safety net. They get medicaid. And it ain't fancy. If you can afford health insurance but you choose not to, well you pay for what you need. If you can't afford it, you made your choice.
If you have a preexisting condition which makes health insurance prohibitively expensive, I think that would qualify for non-fancy medicaid.
All that would be painful as health care providers learn that they must now actually care about cost, and be competitive with the medical group down the street. Three of the four people I had to talk to just to schedule an appointment for a colonoscopy will likely get fired because the butt doctors will need to be competitive on cost."
In general I agree with all of this, especially the part of job eliminating the nonessential people.
I think for most of us here on INGO we might not be on exactly the same page, but we are sure as hell in the same chapter!
Regards,
Doug
I don't care if they employ 10000 people to scope my ass. But of course that's gonna be a determining cause for a higher than necessary price tag. So I get to wonder why all that is necessary. It seems quite obvious to me that the medical profession has become about getting the most people paid as possible. Money is apparently so plentiful that they can hire receptionists for receptionists. There is very little that resembles anything like a free market now. If they had to compete on price it's likely they would need to trim the receptionist department, and possibly the waiting room name caller.
What I had to pay out of pocket wasn't much more than what you paid, but I had the insurance group's "negotiated" discount, which was significant. They were very clear on the bill what I would have paid without their discount, and very clear about what I was responsible for paying. The insurance company didn't pay anything because I have a high-deductible plan.
Contrast with my experience of having a colonoscopy back in the 80s. I think it was the 80s. Anyway, it was back when a regular office visit to my family doctor was about $25. There weren't co-pays. That was the entire cost of a visit. Anyway, my family doctor referred me to a Butt doctor for a colonoscopy. I called the Butt doctor's receptionist on the phone, and made an appointment. I stopped in and picked up a prescription for the prep stuff and the receptionist gave me instructions on what to do. After it was all done I got a bill for around $150 which I had to pay of out of pocket because my deductible hadn't been reached. I don't know if that was a discounted rate as well. I was on an 80/20 plan back then.
Having been through the entire Cancer process and doing the prescribed maintenance for this I have seen/spent more than some make in a year.
I was insured until the economy tanked. Spouse and I both lost coverage at the same time pretty much. I was un-insurable basically being in remission survivor.
My last trip through the tube (Petscan) and the whole process when I felt my health sliding south cost us out of pocket. The cost was ridiculas and the spouse had to cash out her last retirement package to pay for it.
I mention this as all the checks/probes/scans and magic Bull**** came back negative. Still in remission.
The issue, as it turns out, is I am now a Diabetic. We figured this out on our own. Ingo member sitting at my table said I looked like hammered hell. His words.
My response was "I feel like hammered hell".
His response after I explained how I felt.......Check your blood sugar. Spouse rolled out and picked up a simple blood sugar meter. My level was 620. That would be pass out time for some folks.
I told the freaking Doctors the exact same thing I told my buddy. Hell, just checking my blood was to easy and no profit in that.
I am surprised I was not arrested when I confronted these thieves. There excuse was I had a history. My response.....non-trained common man had no medical school and he set me on the right path. There were several 4 letter words that I will not share in here. Also the suggestion to avoid me in public.
Changed doctors and am doing fine. I went to the emergency room at the Eskinazi's on 38th street. Left with the meds and a sheet with a proper diet. Out of pocket was easy on this one.
The system is the problem.
Yet they claim to be short handed on nursing staff. Nurses are out there.
We know a few folks that are nurses. They constantly complain of the cut backs long hours and short handed.
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