patrick.net

Goran_K says

rationing and subsidizing others.

That sounds like all insurance.
We be such socialists.
Coverage depends on the amount of premium one is willing to pay?

HEY YOU says

That sounds like all insurance.

It's quite different for the reasons I explained above, especially the privatized aspect which acts as an inherent cost control.

Yes, all health care has SOME rationing as a natural result of "there aren't infinite doctors". It's just that capitalism solves the S/D graph far more efficiently than socialism.

Booger says

Several things will help tremendously:
Up front pricing.
HSA's with unlimited or much higher contribution amounts.
Ban on medical lawsuits.
Caps on emergency services pricing.
No medical treatment for illegals.
No requirement for treatment of the uninsured.

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

I like the no automatic treatment for illegals. This cost is eaten up by the counties in many states which in turn hurts actual taxpayers.

Goran_K says

It's just that capitalism solves the S/D graph far more efficiently than socialism.

Eliminate ACA & lets see what capitalism/insurance premiums does to a families budget "graph".
It might rhyme with "No one in the middle class will have a tax increase."

HEY YOU says

Eliminate ACA & lets see what capitalism/insurance premiums does to a families budget "graph".
It might rhyme with "No one in the middle class will have a tax increase."

ACA is already done and collapsing, so we'll see what happens soon.

CBOEtrader says

.. whatever the fuck that means has yet to be seen

Kicked my funnybone's butt!
Cracked me up! rofl

Goran_K says

HEY YOU says

That sounds like all insurance.

It's quite different for the reasons I explained above, especially the privatized aspect which acts as an inherent cost control.

Yes, all health care has SOME rationing as a natural result of "there aren't infinite doctors". It's just that capitalism solves the S/D graph far more efficiently than socialism.

Why not advocate for a Capitalist solution then?

mell says

Booger says

Several things will help tremendously:
Up front pricing.
HSA's with unlimited or much higher contribution amounts.
Ban on medical lawsuits.
Caps on emergency services pricing.
No medical treatment for illegals.
No requirement for treatment of the uninsured.

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

You believe a Ban on medical lawsuits is part of a good list?

What happens if you are harmed by someone else actions a/o negligence?

errc says

mell says

Booger says

Several things will help tremendously:
Up front pricing.
HSA's with unlimited or much higher contribution amounts.
Ban on medical lawsuits.
Caps on emergency services pricing.
No medical treatment for illegals.
No requirement for treatment of the uninsured.

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

You believe a Ban on medical lawsuits is part of a good list?

What happens if you are harmed by someone else actions a/o negligence?

A cap may be a good compromise. In other countries you may go to jail if negligence is proven, and/or lose your license. There is no perfect system, a cap on damages paired with possible license revocation and/or jail time may work. The current system allows anybody to mount a lawsuit for whatever money they want which mostly benefits the lawyers and clogs the system, not the victim. There's no doubt that the current system is being abused.

Goran_K says

No need to run or hide.

Average wait times reported in 2016 in a survey done by the Fraser Institute.

New Brunswick: 38.8 weeks
Nova Scotia: 34. 8
P.E.I: 31.4
Newfoundland and Labrador: 26
British Columbia: 25.2
Alberta: 22.9
Manitoba: 20.6
Quebec: 18.9
Saskatchewan: 16.6
Ontario: 15.6

Here's the link to the data from their survey.

I remember the Fraiser institute studies now. That would be Dr. Michael Walker who also writes for Heritage.org. He has been releasing these reports for 25 years trying to get the Canadian government to allow private health insurance. Which I'm sure would be quite lucrative to Dr. Walker. Not a very objective source.

You might want to look at Canadian Institute of Health Study which uses actual patient records and dates from actual records. Fraiser uses a survey that asks docs to estimate what they think the wait time would be and gets something like a 5% return on the survey. Not a very statistically valid way to get data.

anon_38c3f says

You just proved why. The COST.

Unless cost controls are put in place (Obamacare NEVER controlled cost of procedures and care), single payer will bankrupt the country.

You are very confused on terms. ACA isn't single payer or anything close to single payer. It's government subsidized health care insurance.

mell says

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

Goran_K says

.

It's quite different for the reasons I explained above, especially the privatized aspect which acts as an inherent cost control.

Yes, all health care has SOME rationing as a natural result of "there aren't infinite doctors". It's just that capitalism solves the S/D graph far more efficiently than socialism.

So that's why health care costs twice as much in America. The inherent cost control. I knew I was missing something.

bob2356 says

mell says

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

Standard visits all have fixed prices you just don't know them they are billed to the insurance, same for most diagnostics. The majority are standard procedures, probably 80% of procedures who can be priced upfront very easily, if not more. I see no issue here.

bob2356 says

So that's why health care costs twice as much in America. The inherent cost control. I knew I was missing something.

I have $300 individual MAX limits per individual in my plan. I'm perfectly fine with the cost. What you're asking me to do is subsidize the health care of some non-contributor in addition to what I pay for myself already. How is that fair?

How is ppACA worse than what we had before?

If it is worse, why won’t the Republican majority listen to their constituents, keep their promises that they screamed about for years, and Repeal and Replace it?

Maybe you were ignorant to the fact that all these same problems existed before ACA?

Maybe you didn’t know that ACA was written by, and thrusted upon us all, by The Heritage Foundation? The #1 source for Right Wing/“Independent” Government Solutions.

bob2356 says

anon_38c3f says

You just proved why. The COST.

Unless cost controls are put in place (Obamacare NEVER controlled cost of procedures and care), single payer will bankrupt the country.

You are very confused on terms. ACA isn't single payer or anything close to single payer. It's government subsidized health care insurance.

If healthcare was affordable, the government wouldn't have to subsidized the ability to pay for it.

anon_983ac says

bob2356 says

anon_38c3f says

You just proved why. The COST.

Unless cost controls are put in place (Obamacare NEVER controlled cost of procedures and care), single payer will bankrupt the country.

You are very confused on terms. ACA isn't single payer or anything close to single payer. It's government subsidized health care insurance.

If healthcare was affordable, the government wouldn't have to subsidized the ability to pay for it.

You’re conflating health insurance with healthcare. Be smarter

mell says

bob2356 says

mell says

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

Standard visits all have fixed prices you just don't know them they are billed to the insurance, same for most diagnostics. The majority are standard procedures, probably 80% of procedures who can be priced upfront very easily, if not more. I see no issue here.

What bob doesn't realize is that there is this thing called HCPCS (The Healthcare Common Procedure Coding System) that all major insurance companies use for billing. It details pricing for the majority of treatments and procedures. You can get that list from any insurance provider along with the allowance they pay for each one.

anon_983ac says

You can get that list from any insurance provider along with the allowance they pay for each one.

Insurance to healthcare providers & vice versa,you scratch my back,I'll scratch yours.

Pay cash in the free market system & see if your itch is scratched.

Greatest theft of all time- Republicans' TBTF.
At least no wingnuts lost their homes.

This is Obamacare:

anon_983ac says

mell says

bob2356 says

mell says

Good list. This is exactly what a productive discussion on patnet should look like. Upfront pricing would rip the mask off this racket.

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

Standard visits all have fixed prices you just don't know them they are billed to the insurance, same for most diagnostics. The majority are standard procedures, probably 80% of procedures who can be priced upfront very easily, if not more. I see no issue here.

What bob doesn't realize is that there is this thing called HCPCS (The Healthcare Common Procedure Coding System) that all major insurance companies use for billing. It ...

Yes, and if we had upfront pricing one would realize that a Dermatologist charges you $300+ to use one application of cryo spray to remove a sunspot/freckle/wart, which has product costs of maybe 25 cents and takes less than a minute. Now graciously add in 4 more minutes for the consultation/visit and you have $300 for 5 minutes billed. Note that applying the cryo spray takes no skills at all and can be done by yourself or anybody else. If that's not a racket then I'd like to hear what is.

bob2356 says

So that's why health care costs twice as much in America. The inherent cost control. I knew I was missing something.

You are mistaking the disaster we have here w a free market? I put 6 families into ACA plans today. Total annual value of their premiums is > $60k . Total value they are paying < $4k.

Any family that is required to pay the full out of pocket price finds an alternative to the ACA. This is pure cronyism. It has nothing to do w a free market.

bob2356 says

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

Sometimes you do know. That is one reasons why pricing should be upfront. That, and if you don't know, you can still look at the proverbial menu and find out if you entered an expensive restaurant, or a reasonably priced one before you order

bob2356 says

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.

Goran_K says

bob2356 says

Great, How does one price something up front if you don't know what is wrong yet? Goran dodged this question also.

I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.

It is possible at scale. For example, Mayo Clinic negotiates with insurers to handle diagnoses on a fee-for-diagnosis basis, rather than fee for service. The law of large numbers enables the individual variations to cancel each other out, and the flat billing discourages over-utilization.

It is also possible to solve the expert service problem by separating diagnosis from service. For example, if you open the VA to all, they could do diagnoses, then post the diagnosis for competitive bidding by approved providers.

Booger says

Sometimes you do know. That is one reasons why pricing should be upfront. That, and if you don't know, you can still look at the proverbial menu and find out if you entered an expensive restaurant, or a reasonably priced one before you order

Goran_K says

I didn't dodge any question. I said for those procedures/drugs/etc for which we can know. I'm not an MD, or a healthcare professional, and neither are you, so I'll leave it to those who have knowledge and work in that market to determine if that is possible.

I've done substantial work in health care and know quite a bit about the economics of health care for a number of different countries systems. Speak for yourself.

So how does this all work for the procedures that could have a price posted? Why would people go shopping when it's third party payer? What is the incentive? How do they get out of their insurance network to go to a cheaper provider? Nothing stops anyone from shopping now. You can call and ask. What is the triggering event that would suddenly make millions of people shop for providers by price?

Not to mention it would be pissing in the wind anyway. Doctors pay accounts for only 8% of health care spending in the US. If doctors worked for free the cost of health care would still be almost double the rest of the first world.

Single payer is the answer. Those who fear it don't comprehend the proportion of our total health care that's already covered by single payer. Get the remaining third or whatever it is on Medicare, and it lowers off per capita cost substantially. This should be obvious, and the government will set prices. The problem is it's paid by taxes, and god forbid someone pays in more than what goes toward their own health care (even though that's basically the definition of insurance - some take out way more than they put in).

The mantra that the government fucks everything up is just based on paranoia about communism and propaganda from 50 years ago. We won, so we don't have to be opposed to the any efficiencies that the government can bring into services such as health care.

I believe the numbers, that is the amount spent by Medicare - and the health services paid for by that, versus the amount spent by insurance of people under 65 (which includes Medicaid) relative to the services acquired for those expenditures could be put together and presented to the public in a way that would make the correct decision extremely obvious.

Goran_K says

What you're asking me to do is subsidize the health care of some non-contributor in addition to what I pay for myself already. How is that fair?

Yes! That non-contributor should die of a easily treatable ailment. It isn't fair that Goran should have to subsidize someone else's survival.

anon_62240 says

Goran_K says

What you're asking me to do is subsidize the health care of some non-contributor in addition to what I pay for myself already. How is that fair?

Yes! That non-contributor should die of a easily treatable ailment. It isn't fair that Goran should have to subsidize someone else's survival.

"From each according to his ability, to each according to his need"

anon_08dee says

Get the remaining third or whatever it is on Medicare, and it lowers off per capita cost substantially.

How will it do that, the medical treatment will still need to be done, there's no volume discount on treating bodies?

anon_08dee says

This should be obvious, and the government will set prices.

The government already sets the prices with Medicaid and Medicare. That's a big part of the problem, no cost controls. Then add in, doctors can do whatever procedures or treatment they want, and Medicaid and Medicare just pays the bill, no oversight. In fact, Medicare uses a "Pay and Chase" business model and won't investigate fraud unless there is a huge outcry.