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US Health Care Costs - 11/20/2014 1:02:06 PM   
DesideriScuri


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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. That begs the question:

2. Why do procedures and treatments cost so much?

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

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)?

_____________________________

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)
Profile   Post #: 1
RE: US Health Care Costs - 11/20/2014 1:08:37 PM   
DaddySatyr


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From: Pittston, Pennsyltucky
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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?).







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

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RE: US Health Care Costs - 11/20/2014 1:09:28 PM   
Aylee


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Over utilization of specialists and staffing levels in hospitals.

_____________________________

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)
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RE: US Health Care Costs - 11/20/2014 1:33:05 PM   
DomKen


Posts: 19457
Joined: 7/4/2004
From: Chicago, IL
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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.

(in reply to Aylee)
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RE: US Health Care Costs - 11/20/2014 1:37:34 PM   
mnottertail


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quote:

ORIGINAL: DaddySatyr
or make it run, more efficiently (Social Security, anyone?).


Nutsuckers owe social security over 2.7 trillion dollars that they borrowed. But yes, nutsuckers are inept and inefficient, as is the private sector.




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RE: US Health Care Costs - 11/20/2014 1:39:56 PM   
Aylee


Posts: 24103
Joined: 10/14/2007
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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.

_____________________________

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 DomKen)
Profile   Post #: 6
RE: US Health Care Costs - 11/20/2014 2:35:53 PM   
DesideriScuri


Posts: 12225
Joined: 1/18/2012
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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.


_____________________________

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 DaddySatyr)
Profile   Post #: 7
RE: US Health Care Costs - 11/20/2014 2:38:12 PM   
DesideriScuri


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

Who's to blame for the growth of cost of higher education?

_____________________________

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 #: 8
RE: US Health Care Costs - 11/20/2014 2:39:41 PM   
DesideriScuri


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


_____________________________

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 #: 9
RE: US Health Care Costs - 11/20/2014 2:42:50 PM   
kdsub


Posts: 12180
Joined: 8/16/2007
Status: offline
There is one reason Healthcare costs so much...well two actually... Greed and Republicans... Otherwise we would have a decent healthcare system supported by reasonable taxes... like much of the rest of the civilized world. It would be different if we could not REALLY afford it but we can... minus a few F35's and a few New World Order wars.

Butch

_____________________________

Mark Twain:

I don't see any use in having a uniform and arbitrary way of spelling words. We might as well make all clothes alike and cook all dishes alike. Sameness is tiresome; variety is pleasing

(in reply to DesideriScuri)
Profile   Post #: 10
RE: US Health Care Costs - 11/20/2014 3:30:48 PM   
Aylee


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

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.

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.

_____________________________

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 #: 11
RE: US Health Care Costs - 11/20/2014 4:36:05 PM   
DesideriScuri


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

ORIGINAL: kdsub
There is one reason Healthcare costs so much...well two actually... Greed and Republicans... Otherwise we would have a decent healthcare system supported by reasonable taxes... like much of the rest of the civilized world. It would be different if we could not REALLY afford it but we can... minus a few F35's and a few New World Order wars.
Butch


We had "Greed and Republicans" before 1970, which is around the time when US costs and other countries' costs started to diverge. So, that's not likely to be the cause...


_____________________________

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 kdsub)
Profile   Post #: 12
RE: US Health Care Costs - 11/20/2014 4:39:45 PM   
DesideriScuri


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

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

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? Why would innovation stop?

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


_____________________________

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 #: 13
RE: US Health Care Costs - 11/20/2014 6:05:34 PM   
kdsub


Posts: 12180
Joined: 8/16/2007
Status: offline
What do you mean... they diverge because of greed that IS the reason. There can be no other not when the rest of the civilized world is managing their healthcare systems just fine. I could understand a difference in cost if it were reflected in life expectancy... but its NOT. We pay more and die earlier. This crap about long waits for services is just not true. We pay the premium price for drugs that are economical everywhere else in the world.

It is greed plain and simple backed by the Republican party that balks at every attempt to make healthcare, which should be a right, freely accessible to all.

Butch

_____________________________

Mark Twain:

I don't see any use in having a uniform and arbitrary way of spelling words. We might as well make all clothes alike and cook all dishes alike. Sameness is tiresome; variety is pleasing

(in reply to DesideriScuri)
Profile   Post #: 14
RE: US Health Care Costs - 11/20/2014 6:37:40 PM   
Aylee


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

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?)

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.

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.

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.

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.

_____________________________

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 #: 15
RE: US Health Care Costs - 11/20/2014 7:21:57 PM   
DomKen


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

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.

(in reply to DesideriScuri)
Profile   Post #: 16
RE: US Health Care Costs - 11/20/2014 7:23:49 PM   
Aylee


Posts: 24103
Joined: 10/14/2007
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.

Those damn Germans!

_____________________________

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 DomKen)
Profile   Post #: 17
RE: US Health Care Costs - 11/21/2014 4:32:50 AM   
Zonie63


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

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.

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.

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.

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.

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.



(in reply to DesideriScuri)
Profile   Post #: 18
RE: US Health Care Costs - 11/21/2014 3:30:13 PM   
crazyml


Posts: 5568
Joined: 7/3/2007
Status: offline

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

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.

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.

_____________________________

Remember.... There's always somewhere on the planet where it's jackass o'clock.

(in reply to DesideriScuri)
Profile   Post #: 19
RE: US Health Care Costs - 11/21/2014 4:45:24 PM   
DesideriScuri


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

ORIGINAL: kdsub
What do you mean... they diverge because of greed that IS the reason. There can be no other not when the rest of the civilized world is managing their healthcare systems just fine. I could understand a difference in cost if it were reflected in life expectancy... but its NOT. We pay more and die earlier. This crap about long waits for services is just not true. We pay the premium price for drugs that are economical everywhere else in the world.
It is greed plain and simple backed by the Republican party that balks at every attempt to make healthcare, which should be a right, freely accessible to all.
Butch


Who's greed, Butch?


_____________________________

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 kdsub)
Profile   Post #: 20
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