You say that, but you don't even seem to be able to post coherently today, much less understand economics. Yes. Huh? You are mangling the language and the argument. I said that IF it were true that medicare providers were paid 10 cents on the dollar, and IF it were true that medicare payments were 1/3rd of the total healthcare spending, THEN it would be the case that medicare was 5/6th of all healthcare provided. I didn't suggest that Medicare spending was 5/6ths of all health care spending. Who said it was a good thing? I was saying your claim of 10 cents on the dollar was bullshit. barfo
I can only LOL at your logic lately. Seriously. If you got paid $.10 on the $1 at your job, you'd demand a 10x wage increase to at least take home the same pay. Similarly, the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x so it doesn't look like they're gauging just the government. No matter how you slice it, medicare is 1/3 the demand for the doctors' services. Oddly, most of the hospitals are non-profit, yet they charge $800 for a central line kit that costs $20. You'll figure it out one day.
So which is it Denny? Are doctors losing money because medicare only pays 10 cents on the dollar, or are they charging everyone 10x? You are all over the map here. "The harder they work, the more money they lose" is not consistent with "the doctors and hospitals are charging 10x to get their fair pay. And they're charging EVERYONE that 10x". barfo
They're charging 10x. The government is asking them to take $.10 on the dollar, expecting them to work harder and lose more money. It's because the market is distorted by govt. intervention. Like I said, you'll figure it out sooner or later.
Is it? Or is it because they are greedy bastards who are charging the most they can get away with? Just like they would in your fantasy of a completely unfettered market? If we did away with Medicare (which I guess is what you are arguing for - you certainly can't be arguing that the taxpayers should pay more for the current level of Medicare, can you?) then what is your plan? barfo
Hospitals are, for the most part, non-profit. Without that profit motive, it's hard to see how you can call them greedy bastards. But they do have to employ an army of attorneys and people to fill out the bureaucratic paperwork to get paid. What I think is best for health care and all markets is that they're free markets. One of the biggest issues with health care costs now is that the consumer isn't the one paying for the products and services. If the consumer did pay, he'd shop for lower prices and competition for the consumer dollars would drive prices down. Like has already been pointed out, health care basically cost $5 before govt. got involved; there were no big insurance companies involved, etc. People would get their care for free (doctors did 33% of their work pro-bono) if they couldn't afford it, or traded livestock (chickens, pigs, etc.) with doctors for the care. It worked just fine. Insurance for automobiles or homes or anything else doesn't cover tune ups, oil changes, and that sort of thing. It's absurd that health care insurance covers those same sorts of things (maintenance). Maintenance and the vast majority of what people go to the doctors for is still rather cheap in the current environment. A clinic near my house charges cash customers $100 for the first office visit and $70 for other visits for the calendar year. About the price of a tank of gas. The urgent care clinic a few blocks away might be even cheaper. As a cash paying customer, I'd choose the cheaper of the two (the care is comparable), or other factors might drive me to choose the other (I like the doctor better). But with my insurance, I pay $35 or whatever, either place I go, so there is no competition driving the overall prices down. Instead of paying $35 for a flu shot where my health insurance is good, I could easily go to Walmart and get a cheap one there. Insurance is exactly meant to be there for the situations everyone hates about the current system. A $10,000 deductible policy costs $50/month, and you're a LOT less likely to go bankrupt if you need brain surgery, cancer treatment, heart surgery, or other really expensive procedures. Insurance is supposed to cover CATASTROPHES, not pay your ordinary bills. You can see the lack of competition and the decline of quality of service in education, too. I'm not sure you've figured that one out yet, either.
Greed doesn't necessarily have to be about profits. Greed can be about expansion and domination. Or nice offices for the administration. Yes, unfortunately, today's doctor lives in the city and doesn't have anywhere to put a pig, so he wants to be paid in cash. Government didn't cause medical insurance companies to exist. That's baloney. The point about the consumer not having a motivation to seek efficient care is a good one. However your solution to that is an awful one. The 19th century might look real nice to you but the rest of us don't want to go back there. So, you want a free market for the inexpensive part of care, but want to preserve the current situation for the expensive part of care? So someone who needs a $20 treatment will shop around and get the best deal, but someone who needs $20,000,000 of treatment will seek the best, highest price treatment available? Seems like sort of a half-ass solution, if you don't mind me saying so. I guess if flu shots and the like make up the majority of healthcare spending, your plan could work. Do they? I've not seen data on the ratio of current spending on maintenance vs. non-maintenance. My understanding is that HMOs came about because the health insurance companies decided it might be cheaper for them to pay for maintenance so that they would get stuck with fewer major medical bills. Apparently you think that somehow the insurance companies are being forced by the government to pay for maintenance? I don't know of any regulation that says that individual insurance companies can't just drop all their plans except catastrophic coverage. So if they thought that was a good business model, I guess they probably would. The auto insurance analogy doesn't work because auto insurance doesn't cover blowing up your engine because you never changed the oil. If health insurance companies could deny you coverage for a heart transplant because you are fat and lazy and didn't exercise, then they'd have no interest in covering maintenance. Likewise, if auto insurance companies had to pay for a new engine if you ran it out of oil, you can be sure that regular oil changes would be covered. barfo
There is probably more competition in education today than there ever has been. So I'm not sure how you are connecting lack of competition to a decline in quality. barfo
You describe the govt. perfectly, but even now they're giving themselves big bucks salaries and massively generous benefits. Actually, today's doctor specializes because the govt. took all the incentive out of doing the general care thing. Read the articles I posted again. 700 health care insurance companies started up after the govt. started funding care and regulating the industry. Like I said before, it only takes a modest bribe to get the govt. to look the other way while you bill them $600 for a hammer. There you go again with the strawman. Nobody says the 19th century looks better. The 21st century with real competition looks better. Seems like it solves exactly the right solution. 90% (yeah, I looked it up) of the population doesn't require hospitalization or extended care. http://en.wikipedia.org/wiki/Health_Maintenance_Organization_Act_of_1973 HMOs are another product of government. There are 800,000+ pages of regulations requiring them to cover all sorts of things, along with govt. grants. It's not a free market. Ever hear of COBRA? Get it? The wind blew down the fence behind my house. My homeowner's insurance policy covered it.
Yes, greed and corruption certainly exists in government as well as in the private sector (and in the non-profit sector too). Humans are humans. No, today's doctor specializes because the incentives are much greater for specialties, not because there is NO incentive in general care. Are you talking about the rubber hammers that the doctor hits your knee with? I'm not really sure what your point is here. As I posted earlier in this thread, health insurance has been around since George Washington was President. Your utopian vision looks very much like the 19th century to me. Or maybe the 16th century. Certainly not the 21st. Ok, that missed the point entirely. The question was not what percent of the population required that, but what percentage of health care spending it amounted to. Yes, but you missed the part where they are no longer required. Yet they still exist. Why? Yes, I've heard of COBRA. I've heard of SPECTRE, too. What does either one have to do with this? You can't seriously be claiming that COBRA is somehow a significant source of increased healthcare costs? Uhm, who gives a shit? My insurance agent's first name is Donald, as long as we are throwing out insurance-related non-sequiturs. barfo
HMOs are big business and they have govt. in their pockets. COBRA is one of those regulations you want to ignore. If there were no COBRA, the market would be a bit freer. I can see why you want to change the subject. However, for catastrophic health insurance, 100% of the peoples' money should be pooled to pay the benefits of 10% who actually need them. That's per insurance provider. And you said the auto insurance analogy doesn't work. But the home owners' insurance one does (better).
The libertarian solution to that problem is to cut out the government middleman and let big business do whatever they want without even the need to bribe anyone. More efficient, certainly. Better outcome, certainly not. I don't want to ignore COBRA. Given our rather silly employer-based insurance system, it's a great law. Yes, the market would be a bit freer, at the cost of people being instantly uninsured if they lose their jobs. Not a good tradeoff. I do? I'm willing to go on talking about this for as long as you are, maybe longer. Yes, that's how insurance works, all right. You forgot about the profits and overhead for the insurance company, so I'll give you half credit. To some extent. If your house burned down, and the insurance company could prove that you'd failed to fix some problem that resulted in the fire, I'm pretty sure they'd deny your claim. A blown down fence just isn't worth the bother, even if you didn't bother replacing rotted fence posts when you should have. barfo
Better outcome, certainly. You are somehow hooked on "insurance" being the most important thing. I'm hooked on "care" being the most important thing. I had another insurance claim recently. The fuse box was so old and needed repair, but I put it off and did other work on the place. It shorted out the dishwasher which overflowed and flooded the entire first floor. The insurance company told me "you definitely have a claim." They told me to let the water damage guys come and do whatever they felt they needed and that it'd be paid for. They also paid for most of a remodel of the first floor - the difference being that we chose to upgrade the floor tiles and cabinets and build new stairs. So if the insurance companies are so willing to pay that sort of claim, why wouldn't they be willing to pay health care claims? The answer is there's a LOT less regulation, and paying claims is the insurer's business, and if they didn't then I'd switch to one of their competitors.
Not to jump in here, but for barfo (or anyone, for that matter): What part of the Affordable Care Act made any of the care more affordable? It seems to me (and I'm not a scholar on the subject like you guys are) that care is just as expensive--only now there's a government mandate that Patient X (who heretofore had been previously uninsurable, since the costs for his medical treatment for Major Diseases Y and Z were prohibitively high for a private insurance corporation to break even on) will now be able to afford insurance from that private insurance corporation that covers those exorbitant costs, since you and Denny and I are funding the government subsidies of his premium and/or his bill.
I am? That's news to me. I hate insurance, would love to see every one of those bloodsuckers put out of business. It's true, because of the employer-based system, you have little ability to switch insurers. I'd love to see the employer linkage severed. It doesn't have much to do with regulation. barfo
We as a society have decided that it isn't right to let someone die just because they weren't continuously insured. Yes, providing healthcare to the ill costs healthy people money. Providing healthcare to the poor costs wealthier people money. As to your initial question, the PPACA certainly made healthcare a lot more affordable for Patient X, wouldn't you agree? barfo
No. Not in the slightest. The care still costs just as much as before. It's just that someone else is now paying for it. And "we as a society" haven't decided anything. Obama decided it, and scraped together enough congressmen who hadn't read it to push it through. You might just as easily say that "we as a society have decided" that drinking a gosh-danged liter of cola was illegal, since an executive in government has deigned it.
