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RE: US Health Care Costs - 11/21/2014 5:03:38 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: Aylee
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: Aylee
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: Aylee
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: Aylee
staffing levels in hospitals.

I don't know what hospitals you've spent time in but I've unfortunately spent time in several over the last few years and staffing levels can best be described as woefully inadequate.
Health care costs arise from many fronts. First of course is the fact that doctors are saddled with enormous debt which they must recoup. Secondly diagnostic equipment is expensive and its use is increasingly encouraged. Third is the cost of malpractice insurance and settlements but from my discussions with several doctors that is a reasonably small part of their expenses.

Check the administrative staffing.

What are your thoughts in regards to Question #4 in the OP?

My first thought is that there would be a hell of a First Amendment fight on the hands due to the separation of church and state. Then there is the Fourth Amendment, illegal seizures.

WTF does separation of "church and state" have to do with it?

How many hospitals are religious owned not-for-profits? You really think that there would be no problem with the federal government taking over a religious organizations business and land? (And what are you going to do with the nuns?)


According to Wikipedia:
    quote:

    In 2003, of the roughly 3,900 nonfederal, short-term, acute care general hospitals in the United States, the majority—about 62 percent—were nonprofit. The rest included government hospitals (20 percent) and for-profit hospitals (18 percent)


So, 62% are non-profit, and the same article also claims:
    quote:

    Based on their charitable purpose and frequently affiliated with a religious denomination...


quote:

quote:

There would be nothing illegal about it. Ever heard of "eminent domain?"

Yes I have. It is usually done by States and local governments, although often times with fed money. I think that the court cases would drag on for way too many years. Remember, eminent domain means that they can take your property and you can then sue in federal court for payment.


You don't understand eminent domain. Eminent domain forces you to sell your property to the government for a "fair" price (which is usually defined by the government forcing you to sell). Government only has to show that they are taking the property for public benefit (and that sometimes is questionable; case in point, the City of Toledo used eminent domain to take property to sell to Chrysler so they could build a new Jeep plant), and they have to pay you for it. Those lawsuits generally don't go so well for the private owner, sadly enough.

quote:

quote:

With that aside, I think that you would see even more decline in rural health. The ACA is forcing so many small hospitals to close and this would just exacerbate it. You would have longer wait times for imaging and testing.
Equipment innovation in the USA is going to come to a screeching halt. Japan, Israel, and China will quickly overtake the technology. It is a close race right now.
As far as administration goes, judging from higher ed and public schools, it is going to get a hell of a lot worse. Pournelle's Iron Law of Bureaucracy here. Also, if you think about the military as well and the changes since 91 or so.
Let's also consider what unions are going to do to the whole thing. Political hires.
And one other thought. . . the IRS scandal. . . what if all of a sudden republicans or democrats are being denied heart bypass surgery? Or hip replacement?
I think that it would be a mess.

Why would rural health decline?

You may not be aware of this, but rural hospitals do not have the same level of trauma centers that larger areas have. For a long time they have done the "stabilize and move." Because the rural hospitals are having to close, movement to a place to stabilize is getting even further. Survival rate for strokes, heart attacks, traffic fatalities are going down in the rural areas.
Now, how does the government do things? Is their a county health office in every town? Nope. Usually just the county seat. How far are rural folks having to travel now to see PCPs and specialists? Quite a ways. Add all of that together, the health results for rural people are going to go down because of the lack of quick access to EDs.

Why would they have to close if they are taken over by government?

quote:

quote:

Why would innovation stop?

Because the government would decide to purchase X number of 128 slice CT scanners. Currently, hospitals are competing with each other to have the best imaging equipment. If their is no competition, why should GE spend how ever much to advance their imaging equipment, or DaVinci improve their robots, where there is a single set buyer in the US. Think about how Army procurement works. Japan is now selling to the European market their imaging equipment. Will GE really be able to compete? Not so much.


Japan's system is 70%/30% with government footing the 70% part. How is it that they still innovate and yet, their spend is still really fucking low?



quote:

quote:

If government took over administration of hospitals, what would happen to the costs of procedures and treatments?

We really would not know until 3 years later. It would be an averaged cost. So. . . a couple of years later you could lok at the average cost of a knee replacement. The average cost of a tylonal.
I doubt that the cost would be reflective of actual cost.


But, if there is too much staffing at the administrative level, why not leave that to bureaucrats, removing the need for profits?

_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to Aylee)
Profile   Post #: 21
RE: US Health Care Costs - 11/21/2014 5:04:48 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: Aylee
staffing levels in hospitals.

I don't know what hospitals you've spent time in but I've unfortunately spent time in several over the last few years and staffing levels can best be described as woefully inadequate.
Health care costs arise from many fronts. First of course is the fact that doctors are saddled with enormous debt which they must recoup. Secondly diagnostic equipment is expensive and its use is increasingly encouraged. Third is the cost of malpractice insurance and settlements but from my discussions with several doctors that is a reasonably small part of their expenses.

So, you blame equipment makers and higher education?
What kind of profit is an equipment maker making? Is that why it's so high?

primarily the vultures on Wall Street that demand ever higher returns on every investment. But anyone can look at modern imaging equipment and see that it should not cost the amounts that Siemens, for instance, is charging.


Are you claiming that Siemens is making too much in profits, then?

quote:

quote:

Who's to blame for the growth of cost of higher education?
primarily the Republican party. We should have long ago fully socialized higher education. No one should emerge from college with any debt at all.


Any proof?


_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to DomKen)
Profile   Post #: 22
RE: US Health Care Costs - 11/21/2014 5:21:08 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: Zonie63
quote:

ORIGINAL: DesideriScuri
1. Why does Health Care Insurance Cost so much?
I contend that insurance costs so much because cost for treatments and procedures costs so much.

I would not make that assumption. Considering how much insurance companies pay their CEOs and how much they must have spent on their big beautiful expensive office buildings, they surely must have money to burn in the insurance industry. They don't look like they're cutting to the bone.


Costs haven't gone down, even though Obamacare requires them to spend 80% of their premiums directly for care, leaving 20% to pay administrative costs. If the cost of care was slashed, don't you think the cost of insurance would also drop?

quote:

quote:

That begs the question:
2. Why do procedures and treatments cost so much?
3. Is it inflated costing by the hospitals/providers?

I wouldn't put it past them to inflate the costs, although it may not be the hospitals as much as the equipment manufacturers and the pharmaceutical companies. The hospitals themselves may be part of the problem, but I think they're far lower on the food chain. I would also cut the hospitals a bit of slack since they're required by law to treat anyone who requires their services, no matter if they can afford to pay or not. As a result, it's the hospitals and other providers who are forced to eat those costs incurred by deadbeat patients, whereas the insurance companies, equipment manufacturers, and pharmaceutical companies don't have to contend with that. Their attitude is, "Fuck you, pay me."
So, if hospitals have to inflate the costs in other areas to make up for their losses, it may be because they're stuck between a rock and a hard place. Besides, the hospitals are the ones doing the actual work and dealing with the patients on a face-to-face basis, whereas the insurance companies are just sitting in their offices doing absolutely nothing. Kind of like what government bureaucrats do, except bureaucrats are far less expensive than insurance company executives. The equipment manufacturers and pharmaceutical companies are still creating useful products, although they're still buffered and insulated from the actual process of patient care.


So, equipment makers and pharmaceutical companies are making huge profits?

I do believe hospitals get at least some reimbursement from government for "charity care," and that there is a requirement for a certain level of charity care for a hospital to get and maintain "non-profit" status.

quote:

quote:

4. What do you think would happen if the Federal Government took over the Administration of Health Care by running the hospitals? That is, how would costs change if the US Government was the Administrators of the care providers, paying a fair wage to the Administrative staff and only charging what it actually costs to cover the cost of supplies, those administrative costs, and pay the care providers (assuming care providers were self-employed contractors, charging what they wanted)?

They don't really have to take over the administration of healthcare; all they really have to do is impose price controls. However, if they were going to take over administration of healthcare, it would have to entail more than just running the hospitals. They'd have to take over the equipment manufacturers and the pharmaceutical companies as well.
As far as what would happen, one thing that seems apparent is that it would relieve a great deal of pressure off the average working class American, as they would not have to shell out a significant portion of their weekly earnings just to cover health insurance costs. This would free up more disposable income for millions which could then be spent in other sectors and stimulate the economy. Bankruptcies due to high medical bills would also be reduced, and this would also have a positive effect on our economy.


Would price controls really solve the problem, though? Where would you put those controls? That is, at what level would you place the controls? If hospitals are making "too much" profit, you could control those prices to squeeze profits out, but are hospitals making too much profit? Is the profit too high for pharmaceuticals or equipment manufacturers? At what point does the Federal Government get the authority to decide how much a private company can charge for a good?

quote:

I know you and I have had discussions about the Federal government before, particularly the size of government and the level of interference in the private sector. There seems to be an underlying assumption that, no matter what the Federal government chooses to do, they'll always do it badly and inefficiently. This is what feeds the viewpoint that, if the Federal government was put in charge of healthcare, it'll just turn into one big mess of bureaucracy, inefficiency, corruption, and waste.


Actually, more often than not, that is the demonstrated history...

quote:

I will say this: Regardless of how we pay for it, whether through tax dollars or insurance premiums/co-pays, we the taxpayers/insured have every right to expect something for our money.


Are we not getting something for our money? Actually, we may not be. If I pay for insurance coverage, but never use it, I got little or nothing for my money. Same goes for every insurance type. If you don't use it, you've spent money for, pretty much nothing.


_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to Zonie63)
Profile   Post #: 23
RE: US Health Care Costs - 11/21/2014 5:27:10 PM   
Aylee


Posts: 24103
Joined: 10/14/2007
Status: offline
Feds eminent domain a Sisters of Charity hospital. Okay. Now. . . how much to gut the hospital of everything that smacks of religion? Also, what are you going to do with the nuns? You really do not see first amendment issues popping up?

The rural hospitals are closing now because of the ACA. I am suggesting further closures if the feds took over, because of consolidating things to a few areas. Like they do with county health department. Now. . . look at the size of a county like Mesa County, in Colorado.

Using that same area, especially with reference to I-70, why would the feds want to keep open any hospitals in between Denver and Grand Junction and Salt Lake? The areas are sparsely populated, after all.

A slew of union bureaucrats is likely more expensive than what we have now.

I have no idea how Japan runs their hospital systems. But it sounds like some of it is still competitive with each other. My point about technology is that the feds are going to decide to purchase one new CT scanner for 10% of hospitals. The hospitals without a new scanner are not actually competing for patients. So. . . a lot of sales in the US will be loss which leads to smaller R&D budgets.

_____________________________

Ceterum censeo Carthaginem esse delendam

I don’t always wgah’nagl fhtagn. But when I do, I ph’nglui mglw’nafh R’lyeh.

(in reply to DesideriScuri)
Profile   Post #: 24
RE: US Health Care Costs - 11/21/2014 5:28:19 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: crazyml
quote:

ORIGINAL: DesideriScuri
1. Why does Health Care Insurance Cost so much?

Because the existing health care system is so inefficient
quote:

I contend that insurance costs so much because cost for treatments and procedures costs so much. That begs the question:
2. Why do procedures and treatments cost so much?

The procedures and treatments themselves don't cost much, the overheads across the system are where the greatest cost differences lie


Explain, please.

quote:

quote:

3. Is it inflated costing by the hospitals/providers?

"Inflated" is a little inflammatory - the hospitals/providers aren't making obscene profits, but the huge bureaucratic complexity of the system sucks money away from primary care and into supporting the machine.


Expand on this, please.

quote:

quote:

4. What do you think would happen if the Federal Government took over the Administration of Health Care by running the hospitals? That is, how would costs change if the US Government was the Administrators of the care providers, paying a fair wage to the Administrative staff and only charging what it actually costs to cover the cost of supplies, those administrative costs, and pay the care providers (assuming care providers were self-employed contractors, charging what they wanted)?

The US would have the potential to benefit from the kind of healthcare system that the majority of other successful, developed, economies have, in which the same (or better) healthcare is provided universally to citizens for half the total cost.


How so? How will costs be cut, let alone cut in half? You do realize, don't you, that no one has ever been able to demonstrate that costs dropped, right? There is zero proof that costs in the US would drop. The only facts that are out there is that all industrialized countries were spending about the same %GDP (or very close) and now we spend about twice as much. That seems to me that the only thing that was different was the rate of increase in costs. Thus, the only thing we can expect by copying their system, is that our costs will rise at about the same rate as theirs, going forward. That might eventually result in our %GDP spend and theirs meeting up some day, but that would depend greatly on our GDP doubling while their GDP's essentially remain stagnant. I don't see that happening.

_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to crazyml)
Profile   Post #: 25
RE: US Health Care Costs - 11/21/2014 5:32:04 PM   
DomKen


Posts: 19457
Joined: 7/4/2004
From: Chicago, IL
Status: offline
quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: Aylee
staffing levels in hospitals.

I don't know what hospitals you've spent time in but I've unfortunately spent time in several over the last few years and staffing levels can best be described as woefully inadequate.
Health care costs arise from many fronts. First of course is the fact that doctors are saddled with enormous debt which they must recoup. Secondly diagnostic equipment is expensive and its use is increasingly encouraged. Third is the cost of malpractice insurance and settlements but from my discussions with several doctors that is a reasonably small part of their expenses.

So, you blame equipment makers and higher education?
What kind of profit is an equipment maker making? Is that why it's so high?

primarily the vultures on Wall Street that demand ever higher returns on every investment. But anyone can look at modern imaging equipment and see that it should not cost the amounts that Siemens, for instance, is charging.


Are you claiming that Siemens is making too much in profits, then?

Historically corporate profits were acceptable in the 2 to 3% range. No that is considered far too low. So yes, all modern publicly traded corporations that are considered successful are making too much profit.

quote:

quote:

quote:

Who's to blame for the growth of cost of higher education?
primarily the Republican party. We should have long ago fully socialized higher education. No one should emerge from college with any debt at all.


Any proof?

The fact that young people in this country suffer under an ever increasing debt burden due to the spiraling cost of higher education? Did you miss the news that Germany has moved to fully socialize their higher education system?

(in reply to DesideriScuri)
Profile   Post #: 26
RE: US Health Care Costs - 11/21/2014 5:36:06 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: Aylee
Feds eminent domain a Sisters of Charity hospital. Okay. Now. . . how much to gut the hospital of everything that smacks of religion? Also, what are you going to do with the nuns? You really do not see first amendment issues popping up?
The rural hospitals are closing now because of the ACA. I am suggesting further closures if the feds took over, because of consolidating things to a few areas. Like they do with county health department. Now. . . look at the size of a county like Mesa County, in Colorado.
Using that same area, especially with reference to I-70, why would the feds want to keep open any hospitals in between Denver and Grand Junction and Salt Lake? The areas are sparsely populated, after all.


Perhaps they stay open to serve the public? Why are there any hospitals there now?

quote:

A slew of union bureaucrats is likely more expensive than what we have now.


Possibly. But, it could also reduce the number of administrative staffing by consolidation, no?

quote:

I have no idea how Japan runs their hospital systems. But it sounds like some of it is still competitive with each other. My point about technology is that the feds are going to decide to purchase one new CT scanner for 10% of hospitals. The hospitals without a new scanner are not actually competing for patients. So. . . a lot of sales in the US will be loss which leads to smaller R&D budgets.


Does your current CT scanner work, though? It might not be the latest and greatest, but it works just fine. If it doesn't work, then it's replaced. I have to wonder how much input patients actually have in deciding which hospital they are going to spend their money. I know with my twins, we ended up not at the hospital we wanted to deliver at. The hospital we wanted didn't have the level of care necessary, and the specialists we used didn't work at the hospital we preferred that did have the necessary level of care. So, we, essentially, didn't have all that much say in where we were going to deliver.

Then, you look at network hospitals and out-of-network hospitals, etc. For emergency care, it's usually the closest hospital, so the choice isn't really there, either...


_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to Aylee)
Profile   Post #: 27
RE: US Health Care Costs - 11/21/2014 5:37:29 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
Status: offline
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: Aylee
staffing levels in hospitals.

I don't know what hospitals you've spent time in but I've unfortunately spent time in several over the last few years and staffing levels can best be described as woefully inadequate.
Health care costs arise from many fronts. First of course is the fact that doctors are saddled with enormous debt which they must recoup. Secondly diagnostic equipment is expensive and its use is increasingly encouraged. Third is the cost of malpractice insurance and settlements but from my discussions with several doctors that is a reasonably small part of their expenses.

So, you blame equipment makers and higher education?
What kind of profit is an equipment maker making? Is that why it's so high?

primarily the vultures on Wall Street that demand ever higher returns on every investment. But anyone can look at modern imaging equipment and see that it should not cost the amounts that Siemens, for instance, is charging.

Are you claiming that Siemens is making too much in profits, then?

Historically corporate profits were acceptable in the 2 to 3% range. No that is considered far too low. So yes, all modern publicly traded corporations that are considered successful are making too much profit.


Proof for any of that?

quote:

quote:

quote:

quote:

Who's to blame for the growth of cost of higher education?
primarily the Republican party. We should have long ago fully socialized higher education. No one should emerge from college with any debt at all.

Any proof?

The fact that young people in this country suffer under an ever increasing debt burden due to the spiraling cost of higher education? Did you miss the news that Germany has moved to fully socialize their higher education system?


Any proof that it's the GOP's fault, dipshit?


_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to DomKen)
Profile   Post #: 28
RE: US Health Care Costs - 11/21/2014 8:44:39 PM   
Edwynn


Posts: 4105
Joined: 10/26/2008
Status: offline

In the first place, blaming 90-99% of the problem on "the other party" does nothing for the discussion (ascribing that not to the OP, but to "90%" of the other posters here.)

In any case, it doesn't matter how many hospitals are "not-for-profit," the system as a whole is most definitely for-profit, and in too many sectors within the industry, ungodly profits (such as pharmaceuticals and equipment, e.g.), and inflated upper management bloat.

Your point about CT scanners is dead on. It's true that the US does an excellent job re innovation sometimes (no question), but as we see in everyday consumer goods on numerous occasions, not all innovation is about genuine improved usefulness or actual upgrade, but more often about marketing department-driven bells and whistles for competitive selling points.

Also, I can't see why anyone who's dealt with real world insurance/HMO/provider/medical bureaucratic hoo ha would be talking about how the government 'might' make such a hash of it. Maybe one of those "the devil you know" things. In any case, I can't imagine that British or German or Swedish or Danish or Swiss et al. accommodations in either equipment OR pharmaceuticals would be any noticeable downgrade at all from their counterpart in the US. Heck, they make half the drugs and medical equipment for the world (including the US) as it is.

As long as US citizens eat so much crap and have less than stellar lifestyle pursuits (both continually getting worse for decades now), then there will be increasing demand ("increase in quantity demanded," actually) for both medical equipment, medical care, and drugs, and that will continue apace, no matter who's administering what.

Where there is increase in demand (or increase in quantity demanded, either one), innovation follows. The slow increase in bike riders and healthier eaters is no match for the skyrocketing increase in who-knows-what's-put-into normal grocery store food, and the ubiquitous and ever growing fast food chains, and the computer gamers and texter/messengers. The insurance actuaries know ALL that stuff, and it's reflected in our premiums accordingly.

Eating french fries or pizza while playing Grand Theft Auto or Call of Duty while zipping between texting/IM-ing and torrent downloading of 1,000 songs and 200 movies you won't even hear or see is the start in life for too many, now, and the sad continuation for an increasing number. All I can say is, My ETF portfolio is heavily weighted in the healthcare sector, and that will not change anytime soon, no matter the ultimate administrator.

But in any case, rather than ask people who haven't a clue (i.e., in the US) that both healthcare and higher education have way too many 'positive externalizes' (i.e., many benefits for society as a whole, the "money grubbers" and the downtrodden alike, and everybody inbetween) ...

Why don't we just do the logical thing in this case and see how numerous other countries have been doing this very thing, mostly successfully, for decades already?

We have the opportunity to just cherry pick from the 20+ OECD or "Most Developed Countries" that do both healthcare and higher education (and in many cases, primary education) better than in the US, in terms of cost effectiveness, if we properly include "effectiveness" to mean the greatest number of individuals benefited, rather than the greatest benefit to a few individuals.




< Message edited by Edwynn -- 11/21/2014 9:22:49 PM >

(in reply to DesideriScuri)
Profile   Post #: 29
RE: US Health Care Costs - 11/21/2014 8:48:33 PM   
DomKen


Posts: 19457
Joined: 7/4/2004
From: Chicago, IL
Status: offline
quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: DesideriScuri
quote:

ORIGINAL: DomKen
quote:

ORIGINAL: Aylee
staffing levels in hospitals.

I don't know what hospitals you've spent time in but I've unfortunately spent time in several over the last few years and staffing levels can best be described as woefully inadequate.
Health care costs arise from many fronts. First of course is the fact that doctors are saddled with enormous debt which they must recoup. Secondly diagnostic equipment is expensive and its use is increasingly encouraged. Third is the cost of malpractice insurance and settlements but from my discussions with several doctors that is a reasonably small part of their expenses.

So, you blame equipment makers and higher education?
What kind of profit is an equipment maker making? Is that why it's so high?

primarily the vultures on Wall Street that demand ever higher returns on every investment. But anyone can look at modern imaging equipment and see that it should not cost the amounts that Siemens, for instance, is charging.

Are you claiming that Siemens is making too much in profits, then?

Historically corporate profits were acceptable in the 2 to 3% range. No that is considered far too low. So yes, all modern publicly traded corporations that are considered successful are making too much profit.


Proof for any of that?

Read this book.
http://www.amazon.com/Capital-Twenty-First-Century-Thomas-Piketty/dp/1491534656

quote:

quote:

quote:

quote:

quote:

Who's to blame for the growth of cost of higher education?
primarily the Republican party. We should have long ago fully socialized higher education. No one should emerge from college with any debt at all.

Any proof?

The fact that young people in this country suffer under an ever increasing debt burden due to the spiraling cost of higher education? Did you miss the news that Germany has moved to fully socialize their higher education system?


Any proof that it's the GOP's fault, dipshit?


Are you saying the GOP is in favor of socializing higher education?

(in reply to DesideriScuri)
Profile   Post #: 30
RE: US Health Care Costs - 11/21/2014 10:18:49 PM   
Aylee


Posts: 24103
Joined: 10/14/2007
Status: offline

quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: Aylee
Feds eminent domain a Sisters of Charity hospital. Okay. Now. . . how much to gut the hospital of everything that smacks of religion? Also, what are you going to do with the nuns? You really do not see first amendment issues popping up?
The rural hospitals are closing now because of the ACA. I am suggesting further closures if the feds took over, because of consolidating things to a few areas. Like they do with county health department. Now. . . look at the size of a county like Mesa County, in Colorado.
Using that same area, especially with reference to I-70, why would the feds want to keep open any hospitals in between Denver and Grand Junction and Salt Lake? The areas are sparsely populated, after all.


Perhaps they stay open to serve the public? Why are there any hospitals there now?

quote:

A slew of union bureaucrats is likely more expensive than what we have now.


Possibly. But, it could also reduce the number of administrative staffing by consolidation, no?

quote:

I have no idea how Japan runs their hospital systems. But it sounds like some of it is still competitive with each other. My point about technology is that the feds are going to decide to purchase one new CT scanner for 10% of hospitals. The hospitals without a new scanner are not actually competing for patients. So. . . a lot of sales in the US will be loss which leads to smaller R&D budgets.


Does your current CT scanner work, though? It might not be the latest and greatest, but it works just fine. If it doesn't work, then it's replaced. I have to wonder how much input patients actually have in deciding which hospital they are going to spend their money. I know with my twins, we ended up not at the hospital we wanted to deliver at. The hospital we wanted didn't have the level of care necessary, and the specialists we used didn't work at the hospital we preferred that did have the necessary level of care. So, we, essentially, didn't have all that much say in where we were going to deliver.

Then, you look at network hospitals and out-of-network hospitals, etc. For emergency care, it's usually the closest hospital, so the choice isn't really there, either...



They were there usually because they were created by a group of doctors. Because of the ACA rules, though, they are having to close. Or sell to a hospital conglomerate, who then closes because of the small patient traffic. Do you really think the feds are going to keep 16 - 50 bed hospitals open? No. Look at what has happened with Army base hospitals.

I already answered your question about the government and admin bloat. No. Judging by every other area, it will NOT go down.

Imaging equipment. Specifically a CT scanner. You are correct, that by and large a 4 slice CT scanner will take a five image of things. But what if it is a lung patient? They will need a min. of a 16 slice, better a 32 slice. What do you tell them? Drive 4 hours? What about MRIs? Open or closed? And if the patient needs the other kind? Drive 5 hours?

Do you have any idea of the things that can be done with upgraded and newer imaging equipment?

Anyways, frankly your questioning is beginning to remind me of another poster that I have on hide. If you want to discuss this, then fine. I am tired of your attempt at the Socratic method.
Under the ACA imaging centers are closing. The result is going to be longer imaging time waits and more driving.

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Profile   Post #: 31
RE: US Health Care Costs - 11/21/2014 11:10:38 PM   
DaddySatyr


Posts: 9381
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quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: DaddySatyr
Health care doesn't cost so much. We have the AFFORDABLE Care Act, now. Everything is rosy and my insurance didn't go up five and one half times. Everything is good. Stop being a nay-sayer. [/snark]
The federal government taking over anything is not going to bring costs down (Remember $400 D.O.D. hammers?) or make it run, more efficiently (Social Security, anyone?).
In all fairness, it might eventually be a good idea but there will be many needless deaths before the government works out the kinks (or did we learn nothing from the Obummercare website roll out?).


While those are responses, they don't actually answer any question posed.



Perhaps re-check question #4?

quote:

ORIGINAL: DesideriScuri

4. What do you think would happen if the Federal Government took over the Administration of Health Care by running the hospitals?









Screen captures (and pissing on shadows) still RULE! Ya feel me?

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Profile   Post #: 32
RE: US Health Care Costs - 11/21/2014 11:20:49 PM   
Edwynn


Posts: 4105
Joined: 10/26/2008
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A lot of driving is involved in living a rural life, to catch you up on things.

And whatever issues involved in rural medicine are and have been addressed adequately to more than adequately in other countries for decades.

But in any case, no rural hospital or clinic ever closed down before ACA came along, and any such institution that closes down now is strictly because of ACA, you are implying?

Aside from the fact that ACA sucks because Republicans made a point of making absolutely sure that it would suck, let's move on here ...

quote:

Do you have any idea of the things that can be done with upgraded and newer imaging equipment?


Drama as contrived as it is inane. I think I just had a 30 yr. old flashback and now I'm watching an afternoon soap opera. At least as much innovation in medical care and the science behind it, and the biotech and equipment high tech, and the beloved pharmaceuticals, have come from universal healthcare countries as have come from the US.

You know zilch about the economics and incentivisation metrics of anything, so just stop, please.

If you want to insist on reinventing the wheel (but in our mind, 'inventing' it, oblivious to reality and history) and claiming that it lacks the squareness to suit your ideological concept of a proper wheel, then just keep on bumping along on that path, while the rest of the world whizzes down the highway of better and more efficient healthcare.

(their) Rural dwellers included.




< Message edited by Edwynn -- 11/22/2014 12:09:42 AM >

(in reply to Aylee)
Profile   Post #: 33
RE: US Health Care Costs - 11/22/2014 4:32:10 AM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
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quote:

ORIGINAL: DomKen
Are you saying the GOP is in favor of socializing higher education?


Not at all, Ken. That still doesn't explain how the spiraling cost of higher education is the GOP's fault, either.


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What I support:

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  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

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Profile   Post #: 34
RE: US Health Care Costs - 11/22/2014 4:40:38 AM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
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quote:

ORIGINAL: Aylee
They were there usually because they were created by a group of doctors. Because of the ACA rules, though, they are having to close. Or sell to a hospital conglomerate, who then closes because of the small patient traffic. Do you really think the feds are going to keep 16 - 50 bed hospitals open? No. Look at what has happened with Army base hospitals.
I already answered your question about the government and admin bloat. No. Judging by every other area, it will NOT go down.
Imaging equipment. Specifically a CT scanner. You are correct, that by and large a 4 slice CT scanner will take a five image of things. But what if it is a lung patient? They will need a min. of a 16 slice, better a 32 slice. What do you tell them? Drive 4 hours? What about MRIs? Open or closed? And if the patient needs the other kind? Drive 5 hours?
Do you have any idea of the things that can be done with upgraded and newer imaging equipment?
Anyways, frankly your questioning is beginning to remind me of another poster that I have on hide. If you want to discuss this, then fine. I am tired of your attempt at the Socratic method.
Under the ACA imaging centers are closing. The result is going to be longer imaging time waits and more driving.


You think I'm getting like ThompsonX? I have him on hide, too.

I'm looking for discussion. I'll play devil's advocate. You don't have to respond to anything I post, if that bothers you.

How do we reduce the cost of care in the US? Do you at least agree with me that the cost of care in the US is too high?


_____________________________

What I support:

  • A Conservative interpretation of the US Constitution
  • Personal Responsibility
  • Help for the truly needy
  • Limited Government
  • Consumption Tax (non-profit charities and food exempt)

(in reply to Aylee)
Profile   Post #: 35
RE: US Health Care Costs - 11/22/2014 4:57:41 AM   
DomKen


Posts: 19457
Joined: 7/4/2004
From: Chicago, IL
Status: offline
quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: DomKen
Are you saying the GOP is in favor of socializing higher education?


Not at all, Ken. That still doesn't explain how the spiraling cost of higher education is the GOP's fault, either.


Cutting funding to colleges due the never ending drive to "cut taxes and shrink government" is.

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Profile   Post #: 36
RE: US Health Care Costs - 11/22/2014 5:53:01 AM   
thishereboi


Posts: 14463
Joined: 6/19/2008
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quote:

ORIGINAL: Edwynn

Aside from the fact that ACA sucks because Republicans made a point of making absolutely sure that it would suck, let's move on here ...




How did the republicans make sure it would suck?

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Profile   Post #: 37
RE: US Health Care Costs - 11/22/2014 7:00:08 AM   
freedomdwarf1


Posts: 6845
Joined: 10/23/2012
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quote:

ORIGINAL: thishereboi


quote:

ORIGINAL: Edwynn

Aside from the fact that ACA sucks because Republicans made a point of making absolutely sure that it would suck, let's move on here ...




How did the republicans make sure it would suck?

Because the retards watered it down with over 11,000 pages of crap before they would agree to pass it.
11,000 pages of changes that made sure it was sooo far removed from the original proposal that what you ended up with wasn't much better than the clusterfuck you have for healthcare when the ACA finally made it to the people.

I made the same comment a year ago.
The only way you can make it truly affordable, and workable, is to cut out the greedy profiteering insurance companies, eliminating all previously existing conditions, and capping claims; effectively, have a proper socially-funded healthcare system like many of the other successful countries.

Like Edwynn stated - you have the opportunity of cherry-picking the best bits of 20+ OECD countries.
Whichever one you choose has gotta be better than what you have right now.
The GOP really fucked up the ACA from the ground up.


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Profile   Post #: 38
RE: US Health Care Costs - 11/22/2014 7:17:51 AM   
Zonie63


Posts: 2826
Joined: 4/25/2011
From: The Old Pueblo
Status: offline

quote:

ORIGINAL: DesideriScuri

quote:

ORIGINAL: Zonie63
quote:

ORIGINAL: DesideriScuri
1. Why does Health Care Insurance Cost so much?
I contend that insurance costs so much because cost for treatments and procedures costs so much.

I would not make that assumption. Considering how much insurance companies pay their CEOs and how much they must have spent on their big beautiful expensive office buildings, they surely must have money to burn in the insurance industry. They don't look like they're cutting to the bone.


Costs haven't gone down, even though Obamacare requires them to spend 80% of their premiums directly for care, leaving 20% to pay administrative costs. If the cost of care was slashed, don't you think the cost of insurance would also drop?


Possibly, although I have no idea how they plan to enforce that 80% requirement. With my company's insurance plan, we switched from United Healthcare to Blue Cross, although the premiums have been going up. Not just for the cost of care, but for certain optional extras, like Long-Term Disability, Accidental Death and Dismemberment, etc.

quote:


quote:

quote:

That begs the question:
2. Why do procedures and treatments cost so much?
3. Is it inflated costing by the hospitals/providers?

I wouldn't put it past them to inflate the costs, although it may not be the hospitals as much as the equipment manufacturers and the pharmaceutical companies. The hospitals themselves may be part of the problem, but I think they're far lower on the food chain. I would also cut the hospitals a bit of slack since they're required by law to treat anyone who requires their services, no matter if they can afford to pay or not. As a result, it's the hospitals and other providers who are forced to eat those costs incurred by deadbeat patients, whereas the insurance companies, equipment manufacturers, and pharmaceutical companies don't have to contend with that. Their attitude is, "Fuck you, pay me."
So, if hospitals have to inflate the costs in other areas to make up for their losses, it may be because they're stuck between a rock and a hard place. Besides, the hospitals are the ones doing the actual work and dealing with the patients on a face-to-face basis, whereas the insurance companies are just sitting in their offices doing absolutely nothing. Kind of like what government bureaucrats do, except bureaucrats are far less expensive than insurance company executives. The equipment manufacturers and pharmaceutical companies are still creating useful products, although they're still buffered and insulated from the actual process of patient care.


So, equipment makers and pharmaceutical companies are making huge profits?


It would seem so.

quote:


I do believe hospitals get at least some reimbursement from government for "charity care," and that there is a requirement for a certain level of charity care for a hospital to get and maintain "non-profit" status.


Some reimbursement, but not all of it. I know that border States have requested and unsuccessfully sued the Federal government for reimbursement for healthcare costs for undocumented immigrants.

quote:


Would price controls really solve the problem, though? Where would you put those controls? That is, at what level would you place the controls? If hospitals are making "too much" profit, you could control those prices to squeeze profits out, but are hospitals making too much profit? Is the profit too high for pharmaceuticals or equipment manufacturers? At what point does the Federal Government get the authority to decide how much a private company can charge for a good?


When it gets too far out of control and/or could negatively impact the economy or the quality of life for America as a whole. The same authority that allows the Federal government to outlaw or restrict certain drugs, the same authority that allows the gov't. to prohibit people from yelling "fire" in a crowded movie theater. We already give the Federal government the authority to take actions for the public good (as you mentioned eminent domain up above, which is another example of governmental authority). We implemented price controls during WW2 because there was an urgent national need to do so. If there is a crisis in healthcare in this country, then the Federal government has to be given the authority to deal with that crisis - even if it means declaring martial law, as they've done on many occasions during times of crisis.

quote:


quote:

I know you and I have had discussions about the Federal government before, particularly the size of government and the level of interference in the private sector. There seems to be an underlying assumption that, no matter what the Federal government chooses to do, they'll always do it badly and inefficiently. This is what feeds the viewpoint that, if the Federal government was put in charge of healthcare, it'll just turn into one big mess of bureaucracy, inefficiency, corruption, and waste.


Actually, more often than not, that is the demonstrated history...


Not necessarily. History has also shown that the private sector created the Great Depression, whereas government intervention lifted us out of that and built our economy into a powerhouse which was on top of the world during and just after WW2. Leaving the private sector to its own devices would have meant disaster for America. Even before that, the government had to intervene to break up trusts, monopolies, environmental destruction, worker abuse, labor unrest, etc.

quote:


quote:

I will say this: Regardless of how we pay for it, whether through tax dollars or insurance premiums/co-pays, we the taxpayers/insured have every right to expect something for our money.


Are we not getting something for our money? Actually, we may not be. If I pay for insurance coverage, but never use it, I got little or nothing for my money. Same goes for every insurance type. If you don't use it, you've spent money for, pretty much nothing.


I would say that we'd need to compare with other countries regarding what we're paying and what we're getting in return. If other countries can offer better quality care to more people for less money than we're paying, then something is clearly wrong with the way we're doing things. This much is obvious and is not even debatable. This is the point where I begin to doubt the alleged "fiscal responsibility" of conservatism, since they seem to believe that it makes perfect sense to pay the price of Rolls Royce to get a used Pinto.

(in reply to DesideriScuri)
Profile   Post #: 39
RE: US Health Care Costs - 11/22/2014 7:39:50 AM   
freedomdwarf1


Posts: 6845
Joined: 10/23/2012
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quote:

ORIGINAL: DesideriScuri
Japan's system is 70%/30% with government footing the 70% part. How is it that they still innovate and yet, their spend is still really fucking low?



I have explained this to you many times in the past Desi and I've given several examples of how the socially-funded healthcare systems work and actually drive costs down.
Your own graph just shows how they work to keep ever-expanding costs to a minimum.
You keep asking for proof - and there you have it.

What's the essential ingredient missing from social healthcare in all these other countries??
Greedy insurance companies and a cap on legal lawsuites!!

Yes, The Japanese have 30% private healthcare and I believe the Australians have a similar system with a 50/50 split.
How is it they work so well with private healthcare as part of it?
Because the government do not pay the exorbitant private costs - that's how.
Whatever private work is done as part of the general socially-funded care is paid to those private companies at the government rate; not the fully-charged private rate.

This is fundamentally where the US system falls flat on it's face and is soo expensive per person.


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Profile   Post #: 40
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