patrick.net

MMR says

@curious2

If I wanted to start a primary care practice (as opposed to being someone else's bitch), what would you look for in such a practice?

Cash only, so you don't need to employ five ornery fat bitches to do the coding and haggling and arguing with customer and insurance company

Or bring back the original American model: go mobile. No need to pay exorbitant rent for office space, just drive around in your mobile office. Can better assess patients by seeing their home environment and their kitchen. Parlayed with an affinity for nutrition based solutions and a healthy fear of any drug sold by American prescription mills

After hearing all the horror stories about POS veterinarians, we found a Mobile Vet and he is awesome and I recommend him to everyone. He's not even much anymore expensive compared to B&M vets

That's how PCPs operated in this country 100 years ago. Bring it back

So you believe that the costs will increase when the middle man is removed and the administration simplified??

errc says

Cash only

As a business owner I tell you that if you see "Cash Only", it almost always means they avoid paying taxes by not declaring it, and they hire illegals instead of Americans since illegals are paid in cash (way below minimum wage), there are no records that government to force eVerify on them.

Cash only are better to avoid these days in CA.

Our entire corrupt lobbyist system is about trapping ordinary people and then exploiting them.

Medical care is perfect for this. The system is working as designed.

Strategist says

$400 billion divided by a population of almost $40 million is $10,000 per year per person. Where is that money gonna come from?

Half of that number was the 200 billion it now brings in that pays for non heath insurance items and services. So if the typical person paid an additional 5K, but then didn't have to pay for health Insurance and their employer paid them the over 10K they pay for their insurance now, it's actually a win for everyone, no ?

How much if the illegals were excluded?

"The idea behind Senate Bill 562 is to overhaul California’s insurance marketplace, reduce overall health care costs and expand coverage to everyone in the state regardless of immigration status...."

My state income taxes cost me at least 3X what my healthcare costs. You guys don't know how to shop.

Blurtman says

How much if the illegals were excluded?

This would increase illegal immigration and an influx of sick people from other states. People would come here for free services and then go back.
This think is Fucked on Arrival.

marcus says

Strategist says

$400 billion divided by a population of almost $40 million is $10,000 per year per person. Where is that money gonna come from?

Half of that number was the 200 billion it now brings in that pays for non heath insurance items and services. So if the typical person paid an additional 5K, but then didn't have to pay for health Insurance and their employer paid them the over 10K they pay for their insurance now, it's actually a win for everyone, no ?

?? Confusing.

FortWayne says

errc says

Cash only

As a business owner I tell you that if you see "Cash Only", it almost always means they avoid paying taxes by not declaring it, and they hire illegals instead of Americans since illegals are paid in cash (way below minimum wage), there are no records that government to force eVerify on them.

Cash only are better to avoid these days in CA.

The DMV only accepts personal checks and money orders. So amend cash only to cash equivalents. No accepting credit cards so the business inflates all prices 3% just in case they pay Visa/MC. Also, ban all private insurance. They serve no utility to the consumer, rather they bloat costs and complexity by an order of magnitude.

I've asked countless times for people that defend our system of private health insurers, to make their case. Where is their value add? What purpose do they serve? I won't hold my breath

zzyzzx says

My state income taxes cost me at least 3X what my healthcare costs. You guys don't know how to shop.

Or they are not "paying their fair share".

They tried this on Colorado, but when everyone found out they were going to double the size of the state budget, it didn't pass. I think it was called proposition 69. Seriously.

Scare tactics work on the feeble minded

OK all you Freeloading California Tax Payers. Get out your pocket book. There are a lot of people out there who don't work and are depending on YOU to pay for them!!

casandra, when you have nothing intelligent to say, better keep quiet

casandra says

OK all you Freeloading California Tax Payers. Get out your pocket book. There are a lot of people out there who don't work and are depending on YOU to pay for them!!

FP says

casandra, when you have nothing intelligent to say, better keep quiet

She is saying the same thing Brown said.

Strategist, don't make me repeat myself.

rando says

Our entire corrupt lobbyist system is about trapping ordinary people and then exploiting them.

Medical care is perfect for this. The system is working as designed.

Debt is slavery Patrick and you are correct. The Medical Industrial Complex has driven up the cost of health care to where it is unaffordable for the majority. It is the system we live under. A system where if you are not independently wealthy, you are owned by those who are.

errc says

The DMV only accepts personal checks and money orders.

Bullshit: I've just renewed my car's registration last week and paid with credit card. No "convenience fee" either.

Strategist says

This would increase illegal immigration and an influx of sick people from other states. People would come here for free services and then go back.

This think is Fucked on Arrival.

Absolutely, but as those sympathetic to illegals infiltrate CA government, look for logic to fly out the window.

Blurtman says

Strategist says

This would increase illegal immigration and an influx of sick people from other states. People would come here for free services and then go back.


This think is Fucked on Arrival.

Absolutely, but as those sympathetic to illegals infiltrate CA government, look for logic to fly out the window.

I'm been called a freakin socialist for supporting healthcare and education till PhD at taxpayer expense. But it needs to be affordable. We should only have basic health care coverage at tax payer expense, with the rest getting picked up by individuals or employers. Same for eduction, where only those who are qualified should get free education after high school.
In other words......Live Within Our Means.

curious2 says

Since we live in an era of mandatory insurance, I regret to say that insurance coverage is a significant factor.

So maybe a hybrid concierge or dpc approach?

What about accessibility and patient panels?

FortWayne says

As a business owner I tell you that if you see "Cash Only", it almost always means they avoid paying taxes by not declaring it

Interesting...I think a cousin of mine in Arcadia basically said there are a lot of illegal pockets in every town in LA county and that a practice catering to illegals would essentially be a cash-only enterprise.

Two friends/acquaintances of his have armored cars to pick up cash at least once a day if I recall correctly.

errc says

Cash only, so you don't need to employ five ornery fat bitches

Fat sick and nearly dead is wrong message to send patients.

MMR says

So maybe a hybrid concierge or dpc approach?

What about accessibility and patient panels?

I've actually experienced that, and it seems to work fine. One place had negotiated a capitation deal with an HMO, so copayments were trivial, mainly symbolic. Most things don't require meeting specifically with a doctor. The pierced&tattooed person who injects me with vaccines has a real talent for sticking needles into people, but I have no idea what formal education she might have nor how many other people she pierces on a routine basis. She does follow all the right precautions and is also quite cheerful about providing vaccine information, e.g. material safety data and batch/lot, in case of a recall. E-mail and website are available 24/7 for questions, answers follow during business hours.

errc says

Can better assess patients by seeing their home environment and their kitchen. Parlayed with an affinity for nutrition based solutions and a healthy fear of any drug sold by American prescription mills

Definitely lacking at the primary care level.

Strategist says

marcus says

Strategist says

$400 billion divided by a population of almost $40 million is $10,000 per year per person. Where is that money gonna come from?

Half of that number was the 200 billion it now brings in that pays for non heath insurance items and services. So if the typical person paid an additional 5K, but then didn't have to pay for health Insurance and their employer paid them the over 10K they pay for their insurance now, it's actually a win for everyone, no ?

?? Confusing.

Okay, let me try to make it easier for you. That 10K per person would pay for all state taxes and health care too. Where as a lot of families pay well over 10K for just their health insurance now.

Still not getting it ?

marcus says

Okay, let me try to make it easier for you. That 10K per person would pay for all state taxes and health care too. Where as a lot of families pay well over 10K for just their health insurance now.

Still not getting it ?

My understanding is, the cost of health care alone would be $10K per year per person. All other costs would continue on their trend.
Correct me if i am missing something.

Strategist says

the cost of health care alone would be...All other costs would continue on their trend.

If the plan continues to cover all the junk advertised on TV, then yes, the costs would start out high and continue on trend. If coverage were limited to actual health care, cost would fall by half, but CA has no border control, so large numbers of indigent sick people would wagon train from Texas to CA. Single payer fails at the state level because (a) states have no border control and (b) nobody has proposed only covering emergencies and vaccines, rather than the full gamut of chronic whatever. The universal risk of emergencies is the stick that lobbyists use to force more people into the comprehensive insurance policies that they've larded up with overpriced junk; they don't let you buy one without the other. In theory, states could provide free emergency care and vaccine coverage, but lobbyists work the state capitols nearly as thoroughly as the federal one.

curious2 says

Strategist says

the cost of health care alone would be...All other costs would continue on their trend.

If the plan continues to cover all the junk advertised on TV, then yes, the costs would start out high and continue on trend. If coverage were limited to actual health care, cost would fall by half, but CA has no border control, so large numbers of indigent sick people would wagon train from Texas to CA. Single payer fails at the state level because (a) states have no border control and (b) nobody has proposed only covering emergencies and vaccines, rather than the full gamut of chronic whatever. The universal risk of emergencies is the stick that lobbyists use to force more people into the comprehensive insurance policies that they've larded up with overpriced junk; they don't let you buy one without the other. In theory, states could provide free emergency care and vaccine coverag...

Yes, that is why I believe we should provide only basic coverage for all. If you want a sex change operation, heart transplant for a 90 year old, or viagra just to get a hard on, get your own supplemental private insurance, because the tax payer can't afford it.
It should be based on a national health plan, and not for foreigners who have not paid into the system.

marcus says

Okay, let me try to make it easier for you. That 10K per person would pay for all state taxes and health care too. Where as a lot of families pay well over 10K for just their health insurance now.

Still not getting it ?

I believe there are only about 19 million people actually working in California. So you might need to reconsider your math.

The California State and Local government can't even run the budget they have now for basic services like infrastructure without going bankrupt. What faith do you have that California government is sober enough to manage 400 more billion?

http://www.ianwelsh.net/single-payer-healthcare-bernie-sanders-vs-the-wonks/

"Single payer costs less than the American system–about one-third less. Take a look at the chart above and find the Canadian line. Notice what happens after Canada goes from a private to a single payer system—costs drop by about one third compared to the United States."

FP says

Notice what happens after Canada goes from a private to a single payer system—costs....

increased, though more slowly than in the USA. Megan McArdle made this point about all single payer systems. Switching to these systems has not reduced costs compared to what those costs were before. At best, they have slowed the rate of increase.

Meanwhile, Americans over 65 have already had a single payer system for more than 50 years called Medicare. It's become part of the problem, driving costs ever higher.

You have to confront issues of lobbying and influence peddling, otherwise any government program gets captured, and the bigger it is, the bigger the prize.

socal2 says

400 more billion?

It's 200 more billion, which has been my point. But you're right about my arithmetic being wrong, using strategy's 40 million number as number of workers.

Patrick, does this being a free speech forum applies to all kinds of creatures or only to humans?

I am asking because I suspect that curious2 is a monkey who has learned to type. If you are OK with this, can I let my dog try posting on your site too?

So what's to stop people from a different state from coming here for free medical care? The provides can't ask about legal residency! They have to provide care to illegal aliens, so they'd need to provide care also to people from other states!

So NOW the question is this: how does California pay to provide medical care to the entirety of the USA and Central America for free?

www.youtube.com/embed/q2jijuj1ysw

One liners are great.
How much if Republicans were excluded?

Strategist says

It should be based on a national health plan, and not for foreigners who have not paid into the system

You've got my vote. This and a crackdown on illegals might get bi-partisan support.

just_passing_through says

www.youtube.com/embed/q2jijuj1ysw

$900 for a doctor visit? WTF? Even in uber-expensive Bay Area this is somewhere between $150 and $300, IIRC.