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Re: Scott Brown's acceptance speech on Fox News

Postby bleach168 » Thu Jan 21, 2010 6:19 pm

You really can't apply economic theory to the health care industry.

If I walked into an Applebee's and was hungry but couldn't pay and demanded a burger, they would kick me out.
If I walked into a hospital and was bleeding, they would have to take care of me whether or not I could pay.

Anecdotally, as of January 1st, my monthly premiums just went up 17%. Luckily it's 17% of a very low number because I'm young, healthy, and chose a plan that doesn't cover a whole lot. But 17%? What other industry has raised prices 17% this past year?
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Re: Scott Brown's acceptance speech on Fox News

Postby Mookie4ever » Thu Jan 21, 2010 6:32 pm

Getting back to the Scott Brown acceptance speech, I thought the quip about his daughters was funny but he was ripped by Glenn Beck of all people.

Glenn Beck wrote:“I want a chastity belt on this man,” he said, after mentioning Brown’s Cosmo spread. “I want his every move watched in Washington. I don’t trust this guy. … This one could end with a dead intern. I’m just saying, it could end with a dead intern.”


I think that this was a reference to Gary Condit.

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Re: Scott Brown's acceptance speech on Fox News

Postby bigh0rt » Thu Jan 21, 2010 8:09 pm

Madison wrote:Take anything from my link, let's use the ER doc's bill from my link as an example. That bill does not include anything hospital related like testing, the room, etc (all of that stuff is in other bills), all the bill is for is the 10 minutes (or less) he spent asking me a few questions:

Bill - $424, discounted to $339.20. Using the discount numbers, that is:

$2,035.20 per hour.
$16,281.60 per day.
$81,408 per week.
$4,233,216 per year.

Read that again... 4 MILLION?

For one ER doctor that didn't do anything? 8-o That seem reasonable to anyone?

Not that I disagree in the slightest that costs could be lower, because I agree wholeheartedly. However, you're tackling this from the wrong angle. When you pay for the service of most professionals (I dare say any, but I'm sure an exception would be posted and the rest of what I'm about to write completely ignored), you're not necessarily paying for what they do. You're paying for what they know. You're paying the doctor because he can come in and talk to you for 10 minutes and determine a proper course of medical action, whereas you or I can't. Sometimes said action is nothing, phew, danger averted; but this isn't always the case. So, I don't think saying that the fee was unfair because the doctor didn't 'do' anything isn't fair. It's unfair because it's too steep, period, regardless of what was done. At the end of the day, the doctor still went through rigorous schooling to become an absolute master in his field, which is why I understand, to a degree, why medical bills are as high as they are (especially when you consider the cost of the funny little gizmos they use on you that need to be paid off too). So, are medical costs too high? Of course they are. But you can't say that there should be a direct cost scale depending on what the doctor 'does' because if that were the case, they'd just start 'doing' unnecessary things to jack up prices that way. You're paying for the expertise and piece of mind. This is all keeping in mind that taking a 10 minute bill and extrapolating it into an annual salary is ridiculous to begin with ;-) :-b
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Re: Scott Brown's acceptance speech on Fox News

Postby Madison » Fri Jan 22, 2010 2:55 pm

bigh0rt wrote:Not that I disagree in the slightest that costs could be lower, because I agree wholeheartedly. However, you're tackling this from the wrong angle. When you pay for the service of most professionals (I dare say any, but I'm sure an exception would be posted and the rest of what I'm about to write completely ignored), you're not necessarily paying for what they do. You're paying for what they know. You're paying the doctor because he can come in and talk to you for 10 minutes and determine a proper course of medical action, whereas you or I can't. Sometimes said action is nothing, phew, danger averted; but this isn't always the case. So, I don't think saying that the fee was unfair because the doctor didn't 'do' anything isn't fair. It's unfair because it's too steep, period, regardless of what was done. At the end of the day, the doctor still went through rigorous schooling to become an absolute master in his field, which is why I understand, to a degree, why medical bills are as high as they are (especially when you consider the cost of the funny little gizmos they use on you that need to be paid off too). So, are medical costs too high? Of course they are. But you can't say that there should be a direct cost scale depending on what the doctor 'does' because if that were the case, they'd just start 'doing' unnecessary things to jack up prices that way. You're paying for the expertise and piece of mind. This is all keeping in mind that taking a 10 minute bill and extrapolating it into an annual salary is ridiculous to begin with ;-) :-b


True, part of the bill is due to his knowledge, schooling, etc. Goes for all professionals. I don't disagree at all. In this case though, there's no lack of cash flow for the doctor. If you call a plumber, locksmith, lawyer, etc, there's really no guarantee said person is going to have a certain number of clients per day, week, month, etc., so they have to boost their bills a little to cover their own bills, expenses, etc. ER doctors have more clients than they can handle though. So there's zero need for a "premium" to be paid on top of reasonable and fair costs.

Picking apart his schooling is easy since everyone involved knew it was my appendix (was my guess, but the paramedics came to that conclusion on their own). Heck, his bill doesn't even include the tests that the hospital billed me for that confirmed it was my appendix. So his schooling didn't even come into play in this case. Even with the fact that his schooling played zero part in the situation, I do understand he gets more per hour/visit/whatever, simply because he's got the title of "doctor", but that doesn't make it fair or right to rob people at gunpoint. It just adds to the growing problem in the healthcare industry.

And a lot of hospitals/doctors already do procedures that aren't needed or necessary in order to pad their bill.
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Re: Scott Brown's acceptance speech on Fox News

Postby Madison » Sat Jan 23, 2010 12:58 pm

Here's a good example of why the health industry is annoying.

Car mechanics are well trained, go to special schools to get degrees and certifications, and all that jazz like doctors do. Granted, mechanical schools don't cost what doctor schools cost, but the principle is the same. Anyway...

Last week my wife mentions her automatic window button isn't working 100% of the time for making the window go up. Minor inconvenience, but I told her we'd need to get it into the shop when we have some time (but soon). Yesterday the car didn't turn over very quickly when she started it, and her clock had reset. Well I'm no mechanic, but that means to me that there's a problem with something in the electrical system, a short, blown fuse, the "brain", or something in the car. Also figured it could be the battery. So we took it to the shop (Pep Boys, no need to take it to the dealership since a battery isn't covered under warranty), they tested the battery, and found it was bad. Bought a new one that they installed and we were out the door for less than $80. All we paid for was the cost of the battery, even though they checked the old one and installed the new one. No giant bill for the "expertise" involved to figure out the battery was bad since it was simple, much like my appendix was simple to diagnose. Why the difference? Competiton. Hospitals don't have to be competitive, they've got everyone over a barrel. And because of that, they will continue to rob people at gunpoint for the simple fact that they can. If that doesn't change (meaning if the government doesn't force some changes), then the healthcare industry will remain unaffordable for the middle class. And with the current costs being through the roof, I'll support almost anything the government wants to do to bring the actual costs of healthcare down. Forcing mandated insurance doesn't do that, so that's why I didn't support it.


EDIT: And by the way, the window worked fine yesterday, but my wife told me today that it isn't fixed. So while the battery was in fact bad, that doesn't seem to be the only issue. Bah.
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Re: Scott Brown's acceptance speech on Fox News

Postby bigh0rt » Sat Jan 23, 2010 1:19 pm

Madison wrote:Here's a good example of why the health industry is annoying.

Car mechanics are well trained, go to special schools to get degrees and certifications, and all that jazz like doctors do. Granted, mechanical schools don't cost what doctor schools cost, but the principle is the same. Anyway...

Last week my wife mentions her automatic window button isn't working 100% of the time for making the window go up. Minor inconvenience, but I told her we'd need to get it into the shop when we have some time (but soon). Yesterday the car didn't turn over very quickly when she started it, and her clock had reset. Well I'm no mechanic, but that means to me that there's a problem with something in the electrical system, a short, blown fuse, the "brain", or something in the car. Also figured it could be the battery. So we took it to the shop (Pep Boys, no need to take it to the dealership since a battery isn't covered under warranty), they tested the battery, and found it was bad. Bought a new one that they installed and we were out the door for less than $80. All we paid for was the cost of the battery, even though they checked the old one and installed the new one. No giant bill for the "expertise" involved to figure out the battery was bad since it was simple, much like my appendix was simple to diagnose. Why the difference? Competiton. Hospitals don't have to be competitive, they've got everyone over a barrel. And because of that, they will continue to rob people at gunpoint for the simple fact that they can. If that doesn't change (meaning if the government doesn't force some changes), then the healthcare industry will remain unaffordable for the middle class. And with the current costs being through the roof, I'll support almost anything the government wants to do to bring the actual costs of healthcare down. Forcing mandated insurance doesn't do that, so that's why I didn't support it.


EDIT: And by the way, the window worked fine yesterday, but my wife told me today that it isn't fixed. So while the battery was in fact bad, that doesn't seem to be the only issue. Bah.

A few hodgepodge random thoughts here.

1) You can take high school tech program type courses and start interning as a mechanic at 18, being one yourself in another what, 2 years? So at 20 - 21, you can be a fully educated mechanic. The education required to become a doctor is monumentally so much more, it is literally incomparable. You are nearing 30 by the time you are done with your schooling, residency, so on and so forth. You're talking about the difference between running 100 meters and a marathon here. Can you compare the two? Sure. But it's not really a strong indicator of anything. The 'expertise' of a doctor is so far above and beyond the 'expertise' of a mechanic, that I don't think an argument even needs to be made. It's not about the cost of the education (though that does factor here as well), but the level and intensity and time.

2) Doctors are arguably the most important professionals that exist in this country. They deserve to be among the highest paid people in this country due to the nature of their work, and ultimately, keeping people alive and healthy.

3) I could be wrong here, but I believe it was this way with SEARS when I replace my battery, but those diagnostics were only free if you chose to buy the battery from them. Had you chosen to go elsewhere for the battery, you would have been charged for the diagnosing of the problem, etc. (again, I'm pretty sure this is how it worked for me).

4) The motor in your window probably went bad. It's happened to the driver's side window on my last two cars. I want to say it cost like $180 to fix the first time, and the second time I just elected to not be able to open the window, since I have EZ-Pass and don't really get drive-thru often.

5) I always thought you were against the government intervening in pretty much everything? Maybe I'm thinking of Gabe. Either way, I was surprised to see you say, "If that doesn't change (meaning if the government doesn't force some changes)". Again, I could very well be wrong here, or thinking of someone else.

6) Hospitals may not have competition, but specialists do, private practices, etc. and their prices are congruent with the rest of the industry, as far as I'm aware. I admit I'm not 100% up on this topic, nor do I really attempt to be since I have and will always have medical coverage through my job.
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Re: Scott Brown's acceptance speech on Fox News

Postby thedude » Sat Jan 23, 2010 1:39 pm

bigh0rt wrote:
6) Hospitals may not have competition, but specialists do, private practices, etc. and their prices are congruent with the rest of the industry, as far as I'm aware. I admit I'm not 100% up on this topic, nor do I really attempt to be since I have and will always have medical coverage through my job.


Specialists do have competition, or at least recognized to have competition. Look at this way.

Say the price range for one operation* is 100 (for a brand new doctor out of a decent but not great med school) and 500 (for the head of surgery at the best hospital in the area) as set through bargaining with the private health care insurance providers. Which person do you choose? Well it depends, some people will look at the options and choose the cheaper guy because chances are he can do the simple surgery just as well as the more expensive guy. Others might choose the 500 guy because he is the best and they want to take no risks and are willing to pay higher premiums to health insurance providers.

Now the government gets involved and says all doctors must charge a maximum 400 for all surgeries to health insurance and health insurers must pay that amount. Since the competition has been removed for the market and health insurance companies no longer can bargain with doctors ALL doctors (inexperienced and the experience) will thus charge 400. Though the price of the best doctors has decreased, overall the price of all doctors has risen. And there is less incentive to become an experienced expert because you will be paid the same no matter what.

Do you want think the government is better at determining how much a doctor's time is worth or the private health care provider who can actually bargain with a doctor?

*(not emergency b/c then you have whoever is on call at the hospital)

Note this is a simplification of the issue, but the government is notoriously ineffective at determining how much a private individual should charge consumers.
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Re: Scott Brown's acceptance speech on Fox News

Postby Madison » Sat Jan 23, 2010 2:04 pm

bigh0rt wrote:A few hodgepodge random thoughts here.

1) You can take high school tech program type courses and start interning as a mechanic at 18, being one yourself in another what, 2 years? So at 20 - 21, you can be a fully educated mechanic. The education required to become a doctor is monumentally so much more, it is literally incomparable. You are nearing 30 by the time you are done with your schooling, residency, so on and so forth. You're talking about the difference between running 100 meters and a marathon here. Can you compare the two? Sure. But it's not really a strong indicator of anything. The 'expertise' of a doctor is so far above and beyond the 'expertise' of a mechanic, that I don't think an argument even needs to be made. It's not about the cost of the education (though that does factor here as well), but the level and intensity and time.

2) Doctors are arguably the most important professionals that exist in this country. They deserve to be among the highest paid people in this country due to the nature of their work, and ultimately, keeping people alive and healthy.

3) I could be wrong here, but I believe it was this way with SEARS when I replace my battery, but those diagnostics were only free if you chose to buy the battery from them. Had you chosen to go elsewhere for the battery, you would have been charged for the diagnosing of the problem, etc. (again, I'm pretty sure this is how it worked for me).

4) The motor in your window probably went bad. It's happened to the driver's side window on my last two cars. I want to say it cost like $180 to fix the first time, and the second time I just elected to not be able to open the window, since I have EZ-Pass and don't really get drive-thru often.

5) I always thought you were against the government intervening in pretty much everything? Maybe I'm thinking of Gabe. Either way, I was surprised to see you say, "If that doesn't change (meaning if the government doesn't force some changes)". Again, I could very well be wrong here, or thinking of someone else.

6) Hospitals may not have competition, but specialists do, private practices, etc. and their prices are congruent with the rest of the industry, as far as I'm aware. I admit I'm not 100% up on this topic, nor do I really attempt to be since I have and will always have medical coverage through my job.


1) True. The difference in training cost (doctor vs. mechancic) is huge. I even stipulated that. However, I didn't pay one red cent for them to test the old battery, install the new one, talk to a mechanic, or anything. With the surgery, I paid for talking to the ER doc, paid for the equipment used to diagnose me, paid for the supplies used to diagnose me, paid for the doctor that fixed me, paid for the room to recover in, paid for all the items used during recovery, etc, etc, etc. Yet for the exact same thing (but it's a car, not a person), I only paid for the cost of the battery. I didn't pay $5 to talk to a mechanic, $1 for the electricity used to test the battery, $5 for the use of the machine that tested the old battery, $35 for the installation of the new battery, etc, etc, etc. But as to "expertise" in the field, automotive technicians have to know a ton more now than they used to due to so many different types of cars being on the market. And again, in both of my examples, the "expertise" used was extremely limited. Neither were tough problems to figure out.

2) I don't disagree that doctors should be paid well. However, when people are charged $400+ and $300+ (after negotiating) for a less than 10 minute discussion, it's obvious that there is a serious problem in the system.

3) Dunno. I've had a battery test fine before and left without paying anything. Anytime I've had one test bad, I've bought a new one right then and there. So I don't know.

4) I bought a full 100,000 mile, no questions asked, full bumper-to-bumper warranty for the car from the dealership when I bought it, so I'm not concerned about the cost. But I do thank you for the insight, as that would have been helpful if I wasn't under warranty. ;-D

5) Yes, generally I do think the government should keep their noses out of things. Unfortunately, with the healthcare industry being so vital and necessary, and those currently involved with it showing that they don't care about being reasonable, I'd support the government forcing changes on them. I wouldn't like it, but I'd support it.

6) As far as I know, there is no competition when it comes to fighting for patients. No one out there advertises anything like "If you get sick, come see us!". Maybe a dinky little family clinic or something, but certainly no hospital, surgical doctor, or anything like that. The paramedics asked me where I wanted them to take me when my appendix ruptured and I couldn't even name the nearest hospital. That's how little info/advertising is out there. Simply no competition for customers to choose from and get reasonable prices from.
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Re: Scott Brown's acceptance speech on Fox News

Postby KCollins1304 » Sat Jan 23, 2010 2:30 pm

I would argue that when Pep Boys prices their battery at whatever you paid, they factor in things like the labor to install it, to dispose of your old battery, and to test the battery leading to you buying the new one. It just isn't itemized like a hospital bill.
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Re: Scott Brown's acceptance speech on Fox News

Postby Madison » Sat Jan 23, 2010 2:47 pm

KCollins1304 wrote:I would argue that when Pep Boys prices their battery at whatever you paid, they factor in things like the labor to install it, to dispose of your old battery, and to test the battery leading to you buying the new one. It just isn't itemized like a hospital bill.


True, but at $69.99 + tax, am I getting completely robbed and screwed for several years? The car won't go anywhere without a battery, so why not charge $5,000 for the battery and service? Competition plays a part in that. ;-)
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Yes doctor, there will be blood.....
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