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Re: sicko

Postby JTWood » Fri Nov 16, 2007 4:45 am

IllinoisBandit wrote:And seriously people, lots of people get free health care all the time in America. You call for an ambulance, get treated, and then never pay the bill. Poor people do this all the time. Now if you need a transplant or major surgery this obviously won't work (like another poster said, this is not a right, but a privilege), but if you need emergency care it can always be had for free.

I think this is an interesting point. I know it sounds bad, but this is a case where a free market works itself out. Poorer people use the emergency room system to get treatment they necessarily need. It's an expensive service, and some people don't pay the bill. That cost is then passed on to others who can afford to pay the bill, resulting in a de facto tax on the insured as a result of the uninsured. Seems like we already have a pseudo-socialized system, and it does tax the "wealthy" to pay for the medical care of the poor.

Personally, I think the problem here is that the insurance companies have become an unnecessary middle man. They're inefficient and cumbersome, and they do nothing but cost all of us more money. Actually, I think Rugby might have said that earlier. If that's the case... What he said.

:-)
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Re: sicko

Postby Art Vandelay » Fri Nov 16, 2007 9:23 am

JTWood wrote:I think this is an interesting point. I know it sounds bad, but this is a case where a free market works itself out. Poorer people use the emergency room system to get treatment they necessarily need. It's an expensive service, and some people don't pay the bill. That cost is then passed on to others who can afford to pay the bill, resulting in a de facto tax on the insured as a result of the uninsured. Seems like we already have a pseudo-socialized system, and it does tax the "wealthy" to pay for the medical care of the poor.

Personally, I think the problem here is that the insurance companies have become an unnecessary middle man. They're inefficient and cumbersome, and they do nothing but cost all of us more money. Actually, I think Rugby might have said that earlier. If that's the case... What he said.

:-)


The problem is that emergency care is the most expensive method of health care. The poor and uninsured generally don't have access to regular check ups and screenings that could find potential problems, or small problems, before they become big, expensive problems. And because emergency rooms don't turn people away, that's where they all end up, costing all tax payers a lot of money.
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Re: sicko

Postby RugbyD » Fri Nov 16, 2007 9:39 am

JTWood wrote:Personally, I think the problem here is that the insurance companies have become an unnecessary middle man. They're inefficient and cumbersome, and they do nothing but cost all of us more money. Actually, I think Rugby might have said that earlier. If that's the case... What he said.

:-)

Yes and no. The 3rd-party payer system obfuscates information flow about true costs, but the pooling of risk is a powerful tool in providing cost-effective protection. Pooled risk is the lifeblood of all insurance.
TennCare rocks!!!!
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Re: sicko

Postby JTWood » Fri Nov 16, 2007 9:59 am

Art Vandelay wrote:
JTWood wrote:I think this is an interesting point. I know it sounds bad, but this is a case where a free market works itself out. Poorer people use the emergency room system to get treatment they necessarily need. It's an expensive service, and some people don't pay the bill. That cost is then passed on to others who can afford to pay the bill, resulting in a de facto tax on the insured as a result of the uninsured. Seems like we already have a pseudo-socialized system, and it does tax the "wealthy" to pay for the medical care of the poor.

Personally, I think the problem here is that the insurance companies have become an unnecessary middle man. They're inefficient and cumbersome, and they do nothing but cost all of us more money. Actually, I think Rugby might have said that earlier. If that's the case... What he said.

:-)


The problem is that emergency care is the most expensive method of health care. The poor and uninsured generally don't have access to regular check ups and screenings that could find potential problems, or small problems, before they become big, expensive problems. And because emergency rooms don't turn people away, that's where they all end up, costing all tax payers a lot of money.

How's that different than what I said?
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Re: sicko

Postby Art Vandelay » Fri Nov 16, 2007 11:22 am

I don't see it as a case of the free market "working itself out" but rather, a case of the free market screwing itself. Instead of paying lower taxes that could prevent health issues, we wait until small issues are out of control and pay higher taxes to fix them. The people making use of the system would be better off getting early care that would prevent problems than waiting until they are very sick (or otherwise in need of care), and the people actually footing the bill would be better off paying less earlier.
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Re: sicko

Postby Big Pimpin » Fri Nov 16, 2007 11:24 am

Art Vandelay wrote:
JTWood wrote:I think this is an interesting point. I know it sounds bad, but this is a case where a free market works itself out. Poorer people use the emergency room system to get treatment they necessarily need. It's an expensive service, and some people don't pay the bill. That cost is then passed on to others who can afford to pay the bill, resulting in a de facto tax on the insured as a result of the uninsured. Seems like we already have a pseudo-socialized system, and it does tax the "wealthy" to pay for the medical care of the poor.

Personally, I think the problem here is that the insurance companies have become an unnecessary middle man. They're inefficient and cumbersome, and they do nothing but cost all of us more money. Actually, I think Rugby might have said that earlier. If that's the case... What he said.

:-)


The problem is that emergency care is the most expensive method of health care. The poor and uninsured generally don't have access to regular check ups and screenings that could find potential problems, or small problems, before they become big, expensive problems. And because emergency rooms don't turn people away, that's where they all end up, costing all tax payers a lot of money.


Sort of... Some of the uncompensated care/bad debt is picked up through federal program (funded through taxes), but most of it is built into the costs of those who pay. So the hospital, knowing that they're going to be providing some care without reimbursement, raises the prices on it's paying customers (be they uninsured people who come in, are willing to pay, and see higher charges or insurance companies who want that hospital in their network and pay a higher rate to get them in it, resulting in higher premiums to Joe Insured). This same thing happens because Medicaid and Medicare typically pay providers less than the cost of the service, meaning the provider has to pick up that lost revenue somewhere.

If there could be one uniform set of rates with a little bit of variance due to geography and the like (similar to what AcidRock said) that would go a long way. But a single-payer system would be a good way to enforce that. Not that it's the only way, but with the way things are headed I have a tough time seeing how the ship is going to right itself without a kick in the ass from some direction.
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Re: sicko

Postby StlSluggers » Fri Nov 16, 2007 1:05 pm

Art Vandelay wrote:I don't see it as a case of the free market "working itself out" but rather, a case of the free market screwing itself. Instead of paying lower taxes that could prevent health issues, we wait until small issues are out of control and pay higher taxes to fix them. The people making use of the system would be better off getting early care that would prevent problems than waiting until they are very sick (or otherwise in need of care), and the people actually footing the bill would be better off paying less earlier.

I see your point. Have you considered how much we "save" by not offering free preventive care? Sure, getting preventive care will cut down on emergency room visits/costs, but what if the number of people utilizing preventative care are 10, 20, or even 100 times larger the number of people using the emergency room? That difference (future preventative care less current emergency room visitors) is a saving we would give up if those people were to receive free preventative care.

By forfeiting those current savings, we could potentially offset any value saved by preventing an emergency. And that doesn't even take into account standard-issue waste that comes along with anything subject to the "tragedy of the commons" or the possibility that some or many of the emergencies could not have been prevented in the first place.

And just to be clear, I'm sounding cold and calculative in my posts, but I'm not really that way. I believe that that, contrary to other posts in this thread, basic health care should be a right. However, I'm also realistic, and I know that what should be and what will be are almost never in sync.
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Re: sicko

Postby Madison » Fri Nov 16, 2007 1:19 pm

StlSluggers wrote:I believe that that, contrary to other posts in this thread, basic health care should be a right.


Curious, so I'd love to hear your opinion on why you believe that. :-)
Yes doctor, I am sick.
Sick of those who are spineless.
Sick of those who feel self-entitled.
Sick of those who are hypocrites.
Yes doctor, an army is forming.
Yes doctor, there will be a war.
Yes doctor, there will be blood.....
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Re: sicko

Postby Art Vandelay » Fri Nov 16, 2007 1:24 pm

StlSluggers wrote:Have you considered how much we "save" by not offering free preventive care? Sure, getting preventive care will cut down on emergency room visits/costs, but what if the number of people utilizing preventative care are 10, 20, or even 100 times larger the number of people using the emergency room? That difference (future preventative care less current emergency room visitors) is a saving we would give up if those people were to receive free preventative care.

I'm no expert on health care, but I've had the opportunity to interview and have lenghty discussions with quite a few people who are in the past year, and every one of them has said that the money spent on emergency care for people who could have avoided emergency care through preventative care is far more than it would cost to provide simple preventative care for everyone. I'm sure there are arguments and statistics that state otherwise, but just about all of the experts I've talked to are in agreement.
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Re: sicko

Postby StlSluggers » Fri Nov 16, 2007 1:38 pm

Madison wrote:
StlSluggers wrote:I believe that that, contrary to other posts in this thread, basic health care should be a right.


Curious, so I'd love to hear your opinion on why you believe that. :-)

It's just the right thing to do. I understand that the right thing is not always feasible, but I don't like that, either.

Art Vandelay wrote:
StlSluggers wrote:Have you considered how much we "save" by not offering free preventive care? Sure, getting preventive care will cut down on emergency room visits/costs, but what if the number of people utilizing preventative care are 10, 20, or even 100 times larger the number of people using the emergency room? That difference (future preventative care less current emergency room visitors) is a saving we would give up if those people were to receive free preventative care.

I'm no expert on health care, but I've had the opportunity to interview and have lengthy discussions with quite a few people who are in the past year, and every one of them has said that the money spent on emergency care for people who could have avoided emergency care through preventative care is far more than it would cost to provide simple preventative care for everyone. I'm sure there are arguments and statistics that state otherwise, but just about all of the experts I've talked to are in agreement.

I think that we'll end up with some sort of free care for many people one day, so I hope those statistics are right. I wouldn't be surprised if they were wrong, though. As an analyst, I see daily examples of middle managers blowing away the bad data in order to focus on something that will make themselves look good. I'm a little cynical as a result.
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