FCC is on the March Again
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Healthcare can go either way, but the important healthcare, emergency healthcare, there is no free market. When you are unconscious, on the brink of death and being rushed to a hospital you have no ability to haggle on price, ensure that you are getting the same offerings as others, compare doctors, look up quality, choose a facility, etc. Even if conscious no medical facility will give you a price up front. They act as both a regional monopoly (which they are) combined with legalized price and service fixing combined with a federalized labor union program. There is a semi-free market in well care, but for many of us, there is no such thing as well care.
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The question is.. do you believe it can be fixed? If the gov't got out of it all together, stopped paying medicare/medicaid and required people to simply pay their own way... would it be possible?
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@Dashrender said:
The question is.. do you believe it can be fixed? If the gov't got out of it all together, stopped paying medicare/medicaid and required people to simply pay their own way... would it be possible?
No, if the government leaves a utility, it becomes a monopoly. To support a free market, the government must take in over and represent the people. No amount of hatred of government changes this, if the public doesn't own the utilities they are monopolies. To support a free market the government has to do that.
Every working healthcare system in the world is all government controlled and they work great. France, Italy, Canada, Japan, etc. The ones that really shine... they are low cost and 100% government sponsored. They end up paying a fraction what we do while getting superior access to health care and superior health care. There is no way to privatize healthcare without horrific consequences involving cost, quality and freedom.
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You need to get some healthcare in France. They don't just rank #1 in the world according to the WHO, and not only do they require very little tax money to do it (a tiny fraction of what our corrupt system takes in insurance) but the availability and quality of the healthcare is astounding. Even a simple transaction there is staggeringly better than it is here in the US.
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I read the story you posted on SW about your daughter being sick.. but frankly that particular story didn't seem over the top to me. I would really expect the same from a family practice Dr here in the states (but maybe I'm just crazy).
I don't know what percentage of taxes actually go into healthcare in those countries, but I do have a friend in Germany who told me that if you didn't carry private secondary medical insurance, healthcare was pretty bad, they only really gave you the basics.... if you needed a kidney surgery, you might die before it happened. The secondary insurance would put you in a different setup and allow you to get one faster.
In a system that is purportedly free, how do you prevent people from going in for every little cough? Getting any surgery they want done.. etc?
It's my understanding that if you want normal day to day care, then yes absolutely these other health systems are great (things like a cold/flu, broken leg/arm) but if you have cancer or some rare disease, the US is where you want to be. Will it cost an arm and a leg.. almost literally, but you can get the care..
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@Dashrender said:
In a system that is purportedly free, how do you prevent people from going in for every little cough?
Japan studied that and determined that that actually lowers, not raises, the cost of healthcare. Unlimited well visits, while potentially abused, on average prevent more high cost healthcare than they consume in wasted money. So you get a healthier, more productive workforce while spending less on healthcare. Everyone wins.
The American attitude is often that we prefer "fair" and everyone loses to "no fair" but everyone wins. We value "not being taken advantage of" over "doing the best thing for everyone." Both are legitimate moral codes, but Americans pay a huge price for protecting themselves from being taken advantage of. In my mother's terms, Americans generally would prefer to be "dead right" rather than "alive and wrong." They will trade their own health and money in exchange for not letting anyone else get a free ride, even if the free ride benefits everyone.
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@Dashrender said:
It's my understanding that if you want normal day to day care, then yes absolutely these other health systems are great (things like a cold/flu, broken leg/arm) but if you have cancer or some rare disease, the US is where you want to be. Will it cost an arm and a leg.. almost literally, but you can get the care..
If that were the case, people in the US wouldn't so often leave to go other places for healthcare when they can afford it. America pushes that concept, but I don't believe it. I've seen nothing in the American healthcare system to support that theory and the economics of it don't stand up. In the US, everyone is incentivized to keep you sick. In other parts of the world they are incentivized to keep you healthy.
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@Dashrender said:
I read the story you posted on SW about your daughter being sick.. but frankly that particular story didn't seem over the top to me. I would really expect the same from a family practice Dr here in the states (but maybe I'm just crazy).
Expect sure, but you can't actually get it. My local doctor and my local pharmacy would have taken three times as long and cost more than ten times as much (not including the insurance that we have to pay on top of it) for lesser care. And that's my local doctor. In France, we had to use the nearest doctor, not our own. I don't know how you could do that anywhere in the US, let alone while traveling.
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now that I agree with. I'm not sure how the economics work in keeping people healthy... but I do agree that's a major problem in our system.
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@Dashrender said:
now that I agree with. I'm not sure how the economics work in keeping people healthy... but I do agree that's a major problem in our system.
Oh, because in, say, France the doctor gets paid the same no matter what, they don't make extra by seeing you more often. So rather than keep you sick to make more money, they want to make you healthy so that they have more free time for golf, wine and cheese.
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@scottalanmiller said:
@Dashrender said:
I read the story you posted on SW about your daughter being sick.. but frankly that particular story didn't seem over the top to me. I would really expect the same from a family practice Dr here in the states (but maybe I'm just crazy).
Expect sure, but you can't actually get it. My local doctor and my local pharmacy would have taken three times as long and cost more than ten times as much (not including the insurance that we have to pay on top of it) for lesser care. And that's my local doctor. In France, we had to use the nearest doctor, not our own. I don't know how you could do that anywhere in the US, let alone while traveling.
The system there is entirely different.. I'm guessing that a doc in France is paid the same wither they see 100 patients or 1000... so it's in their best interest to keep people healthy so they have less work to do. Obviously that's not the case in the US.. since the amount of money you make it directly proportional to the number of patients you see.
It's like concierge medician. Those docs want to get a ton of patients signed up to pay their up front fee.. and keep them as healthy as possible (allowing them to have more patients on the roaster) so they can do as little work as possible while bringing in the most revenue.
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@Dashrender said:
@scottalanmiller said:
@Dashrender said:
I read the story you posted on SW about your daughter being sick.. but frankly that particular story didn't seem over the top to me. I would really expect the same from a family practice Dr here in the states (but maybe I'm just crazy).
Expect sure, but you can't actually get it. My local doctor and my local pharmacy would have taken three times as long and cost more than ten times as much (not including the insurance that we have to pay on top of it) for lesser care. And that's my local doctor. In France, we had to use the nearest doctor, not our own. I don't know how you could do that anywhere in the US, let alone while traveling.
The system there is entirely different.. I'm guessing that a doc in France is paid the same wither they see 100 patients or 1000... so it's in their best interest to keep people healthy so they have less work to do. Obviously that's not the case in the US.. since the amount of money you make it directly proportional to the number of patients you see.
It's like concierge medician. Those docs want to get a ton of patients signed up to pay their up front fee.. and keep them as healthy as possible (allowing them to have more patients on the roaster) so they can do as little work as possible while bringing in the most revenue.
Only good for the insanely rich, though (I actually have access to one of these - but not because I am rich.) Normal people can't get those. And I don't think that healthcare, like water, should be something that you need to be rich to get. I think everyone should be kept healthy because it is good for everyone.
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@scottalanmiller said:
@Dashrender said:
now that I agree with. I'm not sure how the economics work in keeping people healthy... but I do agree that's a major problem in our system.
Oh, because in, say, France the doctor gets paid the same no matter what, they don't make extra by seeing you more often. So rather than keep you sick to make more money, they want to make you healthy so that they have more free time for golf, wine and cheese.
Then where's the incentive to be a doctor? To spend 4 years as an undergrad, 4 years in medschool, 4-8 more in residency to come out with 100K+ in debt? Maybe they've solved that by having the gov't pay for school, and you still get to earn a 100-150K for non specialty doc.
The sad thing today.. it's practically not worth it to be an internist/GP today. The average internist/GP makes 100K today.. consider the years of schooling, the insane amount of work, the worry of malpractice, the pay definitely doesn't seem worth the efforts.
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@scottalanmiller said:
I think everyone should be kept healthy because it is good for everyone.
And this is the part of your argument (debate) that I do like. It's better for everyone when more people are healthy.. more people can work, you're spending less on healthcare in general, which means more money can be spend on other things in the economy.
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@scottalanmiller said:
Only good for the insanely rich, though (I actually have access to one of these - but not because I am rich.) Normal people can't get those. And I don't think that healthcare, like water, should be something that you need to be rich to get. I think everyone should be kept healthy because it is good for everyone.
Insanely rich? The concierge practice that I support charges $2500 for a single person and $4000 a year for a couple, maybe $5000 for family. Of course you still need normal insurance for any real care.. but I don't consider these prices so high as to only qualify the insanely rich able to afford them.
Another problem we have in this country is that we the people don't care about our own health. We eat McDonald's and Taco Bell daily, prepackaged food galore. If we spend more of income on healthy things like better food, and better sleep spaces we might be a whole lot healthier with that move alone... but we don't want to give up our soda pop and chili cheese fries.
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@Dashrender said:
@scottalanmiller said:
Only good for the insanely rich, though (I actually have access to one of these - but not because I am rich.) Normal people can't get those. And I don't think that healthcare, like water, should be something that you need to be rich to get. I think everyone should be kept healthy because it is good for everyone.
Insanely rich? The concierge practice that I support charges $2500 for a single person and $4000 a year for a couple, maybe $5000 for family. Of course you still need normal insurance for any real care.. but I don't consider these prices so high as to only qualify the insanely rich able to afford them.
Another problem we have in this country is that we the people don't care about our own health. We eat McDonald's and Taco Bell daily, prepackaged food galore. If we spend more of income on healthy things like better food, and better sleep spaces we might be a whole lot healthier with that move alone... but we don't want to give up our soda pop and chili cheese fries.
We also make healthy food impossible to get. Even when you attempt to get something healthy there is no way to know what has happened to it. What is just normal grocery store food in Europe is literally unobtainable here. The government has sold out our food supply too.
$4000 for a family is a lot. When I lived in Texas my insurance was $1700/mo. Add that up. That's $20,400 per year for a family that never gets sick. And it didn't cover anything useful and had really high deductables. So with well visits we paid everything out of pocket. So we actually paid like $24,000 for healthcare, when overall completely healthy, every year. Add concierge on top of that and we are at $28,000 per year without ever actually seeing a doctor for anything! That is, quite frankly, only available to the rich.
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I'm not sure about your situation, but I believe the concierge doctor here would see your Wells is its for free or consider included in your base price. That would reduce your from Ella reduce you from 28 down to 24k.
granted not cheap but really not that much more expensive than what you were paying for the base healthcare insurance. -
it would be awesome to see a new type of health insurance that pays for major medical and not minor things like doctor visits medication refills even if you want say doesn't include things like broken bones. something akin to term life insurance.
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Having made use of the Healthcare system in Japan for my wife and daughters last year, I can tell you it is night and day compared to the system in the US.
Children's standard services are fully reimbursed. Hanna went on for a rash last summer. Came out with medicinal cream. We paid nothing. My wife had an infection of some kind on her foot and came out with medicine and such paying the 30% copay that is paid for all services.All we had to pay was the monthly tax rate for the family for the three months they were in Japan. Paying said tax qualifies a person for all government services, not just healthcare. Japan had a stimulus thing going on for families with children. So she received that as well for those three months.
Compared to the US where I have been in the private insurance market for years before the ACA. I pay $600 a month for health insurance and $100 a month for dental insurance. Dental visits for my wife and I are never 100% covered even with no cavities or other work to be done. Dental visits for the kids are nearly $100 after the insurance because the dentist is considered a specialist because he is a pediatric dentist only. Prior to the ACA I had to pay a copay for every single well child visit. My deductible is $2000 per person and/or $4000 for the family. But my plan (which I will lose next year) is a 100% coverage plan. Not a typical 80/20. This is the only big complaint I have with the ACA, there is no 100/0 plan available, and nothing in the private market is retaining a 100/0 plan that I can find.
Yes I could have a lower monthly premium with an 80/20 plan. Much lower in fact. But fuck that. If I get a severe illness, I don't want to have to come up with 20% of a $50,000 medical bill.
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@JaredBusch There are plans (maybe not through the Health Exchanges). My high deductible plan plan is a LOT higher than yours $5250 for single, and $10500 for family, but it is a 100% (of covered items) after I meet my deductible. There are no copays either, I pay 100% of the high deductible first, after that the insurance company pays the rest. The insurance cost for me (total) through my company is $3081.50, of which I have to pay $523.80.
