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Postby Absolutely Adequate » Fri Nov 03, 2006 5:54 pm

Big Pimpin wrote:
Absolutely Adequate wrote:We can all agree, though, that the US does have a big problem with our health care system, can't we?


I don't really think so, but that's just me. I do, however, think we need to limit a doc's liability, which (as Mook pointed out earlier) would bring down malpractice lawsuits, insurance premiums, and consequently some of the costs. But other than that I don't see a whole lot of issues.


We have one of the highest per-capita costs of healthcare in the world (if not the very highest) and we are ranked 37th overall in the world. If that's OK with you, then I guess you're right that we don't have a problem. But I'd like to either pay less or get better service, myself.
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Postby AcidRock23 » Fri Nov 03, 2006 6:06 pm

Another 'cost' is that fact that hospitals are required to provide care for people w/ no $$$ since the current model of governmental 'insurance' (sic) covers many procedures only fractionally. To stay in business, hospitals and other medical providers have to overcharge people with insurance. Insurance is typically priced at a level designed to make sure that the insurer doesn't take a beating so the people funding this sort of treatment are health care consumers who pay at a higher rate than they would if the government would be socially responsible and take action to manage this shortfall more effectively. It is not unmanageable but they would have to try rather than spitting pennies into the wind. Privatization is a joke.

As the demographic wave hits (my dad was born in 1942, just as my grandfather left for the Army so he is 64 now and is a bit older than the traditional baby boomers who were born after the war, when soldiers returned to peace, prosperity and families...), the health care system will face a tremendous burden. I don't think that there is really enough oil in Iraq to fund the care of these people and we would be better served to make investments in our economy, infrastructure and education just like we did after WWII when the economy boomed for about 25 years in a row.

Which also gets into my other idea of splitting Iraq into 3 chunks and selling it to Turkey, Iran and the Saudis so THEY can play find the car bombs instead of us. Take the money and run....
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Postby Big Pimpin » Fri Nov 03, 2006 6:23 pm

Absolutely Adequate wrote:
Big Pimpin wrote:
Absolutely Adequate wrote:We can all agree, though, that the US does have a big problem with our health care system, can't we?


I don't really think so, but that's just me. I do, however, think we need to limit a doc's liability, which (as Mook pointed out earlier) would bring down malpractice lawsuits, insurance premiums, and consequently some of the costs. But other than that I don't see a whole lot of issues.


We have one of the highest per-capita costs of healthcare in the world (if not the very highest) and we are ranked 37th overall in the world. If that's OK with you, then I guess you're right that we don't have a problem. But I'd like to either pay less or get better service, myself.


First off, it's nice to see you cite a 10-year-old study. ;-7 ;-D

Secondly, I pay about $220/month for insurance for me, my wife, and two daughters. And I've never once in my life struggled with access issues. So I'm fine with that. B-)
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Postby Coppermine » Fri Nov 03, 2006 6:26 pm

So basically, even with adequate health insurance provided by your employers, you're still paying for those without adequate insurance. That pretty much blows the "I'm not paying for lazy people's healthcare" argument. After all, we are the most "advanced" nation in the world, I would say that it would be pretty pathetic in the grand scheme of things if people died in the streets due to lack of health care in this country.

I'd gladly pay some higher taxes if it meant I didn't need to concern myself with the frustrations of insurance and deductibles and all that; I pay nearly $50 a month out of my paycheck for my health insurance anyway. Large companies lay off workers because they can't afford health coverage. How is that promoting a just society?

I see, the point from both ends, and I certainly lean more towards the universal health care idea. I admit I don't know a lot about the pros and cons of each side, but I think it's at least worth discussion.
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Postby Big Pimpin » Fri Nov 03, 2006 6:40 pm

AcidRock23 wrote:Another 'cost' is that fact that hospitals are required to provide care for people w/ no $$$ since the current model of governmental 'insurance' (sic) covers many procedures only fractionally. To stay in business, hospitals and other medical providers have to overcharge people with insurance. Insurance is typically priced at a level designed to make sure that the insurer doesn't take a beating so the people funding this sort of treatment are health care consumers who pay at a higher rate than they would if the government would be socially responsible and take action to manage this shortfall more effectively. It is not unmanageable but they would have to try rather than spitting pennies into the wind. Privatization is a joke.


It's called cost shifting. But those who are commercially insured aren't the ones who get screwed. Most of the large insurers have such large blocks of business that they get pretty sweet deals from the providers. You can basically equate it to "buying in bulk." But you're right, the government is a terrible reimburser of healthcare services. Medicaid is probably the worst payor, and Medicaid isn't a whole lot better. But the people that really get screwed are the private payors, those without coverage or very limited coverage. Makes a good argument for getting rif of public welfare programs such as Medicaid and Medicare, doesn't it? O:-)

AcidRock23 wrote:As the demographic wave hits (my dad was born in 1942, just as my grandfather left for the Army so he is 64 now and is a bit older than the traditional baby boomers who were born after the war, when soldiers returned to peace, prosperity and families...), the health care system will face a tremendous burden. I don't think that there is really enough oil in Iraq to fund the care of these people and we would be better served to make investments in our economy, infrastructure and education just like we did after WWII when the economy boomed for about 25 years in a row.


I think I follow. i think you're saying that just because our society as a whole is getting older, it's going to mean more expensive procedures and such that correspond to an older population, and therefore more burden on the healthcare system as a whole. I can't really dispute that, I think it's just the way things are. If anything it says something about how good our healthcare system actually is that we have this problem. It would be much better if life expectancy went down, wouldn't it? ;-7

And as far as I'm concerned, we should do completely away with government involvement in infrastructure, education, and the economy and let the private sector work.

AcidRock23 wrote:Which also gets into my other idea of splitting Iraq into 3 chunks and selling it to Turkey, Iran and the Saudis so THEY can play find the car bombs instead of us. Take the money and run....


In theory that's a swell idea, but what makes you think that we actually "own" Iraq and therefore can sell it?
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Postby AcidRock23 » Fri Nov 03, 2006 6:42 pm

And, since the baby boomers are still largely working, your costs are likely to start rising significantly in the next few years. People born in 1941 are not boomers but they are turning 65 this year. The real boom didn't start until 1946 or so, as a barrage of babies came out of the war and the post war prosperity was able to fund large families to boot.

A sudden heap of old people + a health care system which relies on expensive precautionary tests for what in many cases minor complaints (eg MRI for 'back pain;) or even lifestyle evaluation ('cardiological tests' every year b/c you are 50, colonoscopy to exclude prostate cance, etc. a few years ago, many people w/ these afflictions were stricken from the books. Now we can pay for the tests for everyone and treatment for those who need it. Which is good but the cost is what I am talking about and what society will pay...).

I'm not trying to say that medicine is bad, but that it is expensive and the demographically significant number people who are going to 1) stop working and 2) continue needing medical care is going to cost money. While participating in an economy where the large manufacturing type of jobs and consumer goods which fueled the childbearing decisions of those folks in the 50s and 60s are leaving.
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Postby Big Pimpin » Fri Nov 03, 2006 6:56 pm

Coppermine wrote:So basically, even with adequate health insurance provided by your employers, you're still paying for those without adequate insurance. That pretty much blows the "I'm not paying for lazy people's healthcare" argument. After all, we are the most "advanced" nation in the world, I would say that it would be pretty pathetic in the grand scheme of things if people died in the streets due to lack of health care in this country.

I'd gladly pay some higher taxes if it meant I didn't need to concern myself with the frustrations of insurance and deductibles and all that; I pay nearly $50 a month out of my paycheck for my health insurance anyway. Large companies lay off workers because they can't afford health coverage. How is that promoting a just society?

I see, the point from both ends, and I certainly lean more towards the universal health care idea. I admit I don't know a lot about the pros and cons of each side, but I think it's at least worth discussion.


See my other post, those of us who are commercially insured are not bearing the brunt of the costs. The fact is you can't protect people from themselves. Take-up rates are never 100%, even for free products such as Medicaid. I would be fine with some kind of system, be it tax breaks or whatever, that encourages (or even funds perhaps) preventive care. The biggest problem IMO is that people who aren't covered at all don't go to the doc until it's too late, and it results in very costly procedures.

I also don't think that we need to create a "just" society. There are haves and have-nots. I pride myself in working to get where I'm at, and see no reason I shouldn't. Anyone else out there has the same avenues available to him or her.
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Postby AcidRock23 » Fri Nov 03, 2006 7:14 pm

Big Pimpin wrote: See my other post, those of us who are commercially insured are not bearing the brunt of the costs.


I am not sure I agree w/ that. Neither hospitals nor insurance companies lose money so the people paying what Medicare/ Medicaid don't pay (again often astonishing amounts...) are the people 'balancing the books' by paying premiums to cover costs. I totally agree that a couple of hundred bucks a month is very reasonable but is $300 or $400 or $500? None of those figures are beyond the realm of possibility as the aging population grows. We are all going to have to choose how to share the cost. Ignoring it and printing money are options that will have costs too. Or, if the government would perhaps do some sort of study that would show that we DO, in fact, have plenty of cash lying around, I would certainly like to take a look at their figures... ;-D
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Postby Big Pimpin » Fri Nov 03, 2006 7:27 pm

AcidRock23 wrote:
Big Pimpin wrote: See my other post, those of us who are commercially insured are not bearing the brunt of the costs.


I am not sure I agree w/ that. Neither hospitals nor insurance companies lose money so the people paying what Medicare/ Medicaid don't pay (again often astonishing amounts...) are the people 'balancing the books' by paying premiums to cover costs. I totally agree that a couple of hundred bucks a month is very reasonable but is $300 or $400 or $500? None of those figures are beyond the realm of possibility as the aging population grows. We are all going to have to choose how to share the cost. Ignoring it and printing money are options that will have costs too. Or, if the government would perhaps do some sort of study that would show that we DO, in fact, have plenty of cash lying around, I would certainly like to take a look at their figures... ;-D


I should not say that those of us insured don't bear the brunt of it. Maybe that language is too strong. We undoubtedly pay some of it. However, insurance companies are competing in a capitalist market, and you can bet damn well that they're going to leverage some of their competetive advantages into as low of rates as possible in order to still make money and also attract new customers.

But the other thing you have to realize is that premiums don't simply get passed through to the providers. Blue Cross (for instance) collects a bunch of money from everyone who they've got under their umbrella, and then pays claims on those who receive services. Then they have deals in place with providers as to how much they pay. So, when a hospital takes a big hit from the government programs, they may up their prices, and maybe Blue Cross has less of a sweet deal, but they still have a deal nonetheless. The people who go in for service and can pay but don't have insurance really get screwed. But there are less of them than there are insured, so those insured would certainly take on a portion of it.
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Postby AcidRock23 » Fri Nov 03, 2006 7:35 pm

To toss out some numbers that are lying behind my blathering, Ferguson's book Colossus cites a 2003 study by Jagadeesh Gokhale, a senior economist at the Federal Reserve and Kent Smetters, the former assistant secretary of economic policy at the US Treasury. This study asked if the government could get its hands on all revenue it can expect to collect in the future but had to use it to pay off 'all future expenditure commitments, including debt service' and answered no, itemizing the shortfall at $45 trillion (12 times the 'official debt' at that time or 'about four times the country's annual output'. They also calculated how the government might meet the expected growth in payments (this as 77 million baby boomers hit retirement in about 3 years...) and determined that they could 1) increase income taxes 69% 2) Increase payroll taxes 95% 3) cut federal purchases 100% or cut Social Security and Medicare 56%.

Ferguson concludes on this study that 'the news is so bad that scarcely anyone believes it'. [Niall Ferguson, Colossus, (c) 2004 NYC The Penguin Press pp 270-271]. It is a dense (at least for me) 300 page book but is pretty interesting stuff.
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