patrick.net

OO says

I will look at medical service the other way, how far down it is on the cost and adoption curve.
Cancer drug? Essential, but unaffordable. Nobody can really afford cancer drug if he needs to pay entirely out of pocket. Pain-reliever? Non-essential in some circumstances, but the cost is low enough that we can send everyone a free pack.
For something that is very expensive and unaffordable concerning life and death, and a constant group of people will get it, insurance (government administered or not) is necessary, or only multi-millionaires can afford it. For something that is cheap, regardless of incidence, then the payer should be responsible themselves. For something that is moderately expensive and everyone will have it one way or another, like pregnancy, government should subsidize only partially, but not pay for all.

I disagree on the pain medication issue. Personally, I have chronic pain. My medications are not optional, they're what make me functional. If I had to pay full price at current prices I'd be at over $500 per month. Tweaked back meds optional - if you have any pain, it's serious to you.

The medical profession now looks at four vitals: respirations, pulse rate, blood pressure, and pain level. Don't fuck with my pain meds. And, for people who have a morphine pump, you're talking thousands of dollars each month. Don't fuck with theirs either.

Issues that don't appear to be serious to you are serious nonetheless. A patient who desperately needs open heart surgery can't get it if he has a toothache - because that toothache could cause a bacterial infection that will kill the patient. However, under your proposal he would have to pay for the toothache himself. What if he can't afford it? I know it seems farfetched, but people die because of toothaches combined with comorbidities.

The problem is that medical care shouldn't be optional Period. Who's to say what's serious, and what's not? A sprained ankle might seem like nothing, or it could actually be broken and lead to a systemic infection. However, if he has to pay for the treatment himself, the person might stay home and ice the ankle.

I'm saying that currently people who have no idea as to what is serious or medically necessary are making decisions, just as you are proposing an asinine payor system. Prices for routine services wouldn't cost less if people paid out of pocket - routine services wouldn't be an option for many people and they would end up sicker & costing the system more. It's stepping over dollars to pick up pennies.

Health Insurance shouldn't be for profit. HMO's shouldn't be rewarded for keeping costs down by denying benefits. Lobbyists shouldn't be paid high dollars to ensure legislation is beneficial to their clients. Fat should be cut, fraud should be prosecuted to the fullest extent of the law.

Healthcare shouldn't be optional. Period.

theoakman says

At one time, we did have the #1 health care system in the entire world. It started to deteriorate when the US Government decided it should become an active player. If anyone thinks that physicians wouldn’t offer full services year round at any time for half of what people pay in that year for health insurance, they are nuts. Any service that is not insured by insurance companies or the government, such as laser eye surgery, has not only become better but it’s also become cheaper over the past 10 years. Not only that, if you open the newspaper, you see physicians actively advertising their prices to attract customers. The proponents of a single payer system conveniently ignore these facts. They ignore that the doctor will charge you more to stich up your forehead when you hit it than they will for performing breast implant surgery. Medicaid, Medicare, and Giant HMOs are the problem.
Btw…the ultimate solution to this problem is to stop restricting entry into the health professions fields. We have thousands of kids who go to college wanting to be doctors and they get turned away, some for good reason, others for not so good reason. Many like to argue that we need to weed out the people and can only let our nations brightest enter Medical School. To those people, I would suggest that you actually go visit a medical school and talk to them. You’ll find that most of them are average people and realistically, there’s nothing that distinguishes them from the majority of people in this country. If you flooded the country with new physicians, you would see prices collapse. Oh yeah, but before you even try that, you have to get the government to stop subsidizing student loans and driving up the price of school.

Elective surgery should certainly be competitive and offered on the free market -- without ANY insurance involvement.

But most hospital visits are NOT elective. I do not have any choice whatsoever in an emergency situation. Have you ever had a doctor tell you how much something was going to cost before they administered the treatment?

A hospital charges, on average, around $30 for a bag of saline. Yeah, that's $30 for a bag of sterile saltwater that costs them less than $0.25 directly from the manufacturers. Have you ever been told the price of saline in a hospital?

The single payer system can be exploited somewhat, but it can only be exploited so far. The hospitals can't just charge whatever they want.

I just got another bill from the hospital where my son was born over 4 months ago. Despite having maxed out my supposed annual out of pocket limit, I'm now getting a $389 bill for some tests they ran on my son. Apparently the per-person deductible still applies to him, so I have to pony up another $300 this year. I've already paid over $200, so I'll most likely only have to pay $100 more, but I'm still getting the bill from the hospital.

How is this system NOT broken? Why am I getting a bill FOUR MONTHS after the last time we were inside the hospital? Why do I have to call the hospital, the insurance company, and the billing company that the hospital contracts out to just to resolve what should be a very cut and dry service?

Every single thing that they do in a hospital is detailed electronically and filed a few minutes. Bills are sent to insurance companies electronically. There is no rational explanation for why I get a bill 4 months after the fact that is clearly more than I owe other than fraud.

This system is completely and fundamentally broken, and it can not be 'fixed'. It must be replaced with something better -- just about anything would do.

Elliemae, the only reason your pain meds cost so much is because the government makes them. In a free society, your pain meds would cost the same as tylenol. Trust me...I'm a chemist. There's nothing magical about your pain meds that make them more expensive. This is a classic case of the government breaking your leg and then giving you a crutch. Once they supply you with the crutch, they somehow convinced you that you wouldn't be walking without them.

Amen, Kevin.

Your comment about elective surgery is amusing to me. Elective surgery is any surgery that isn't emergent. For instance, if a patient needs his gallbladder removed and is in horrible pain & distress, this is probably elective because it can be scheduled for a future time. Breast reduction surgery is usually elective too, even though the woman may suffer horrible back pain, deformity and skin ulcers.

As long as definitions can be manipulated, such as emergent and elective and serious and not-for-profit, our system will continue to deny benefits.

Cancer drugs are not essential. In fact, they literally kill you. You'd be surprised at how many people wish they didn't get cancer treatment. If you think water boarding is bad...try chemo...

If you think healthcare is just fine the way it is, please take a look at this woman's presentation of her adventure in healthcare. She had an infection, which was treated. It took her two years to even determine fair and reasonable charges so that she could pay her bill. It is fascinating, and quite useful if you should ever need to determine the industry standards for hospital charges.

http://www.youtube.com/watch?v=wRsBFACxbB4

theoakman says

Cancer drugs are not essential. In fact, they literally kill you. You’d be surprised at how many people wish they didn’t get cancer treatment. If you think water boarding is bad…try chemo…

Oh, you are so correct. But they're not supposed to make you better. They're supposed to kill the cancer - but the side effects are horrible and often extend the quantity of life, not the quality. There are some exceptions.

I do believe that my pain meds are cheap for the manufacturer. My point was that when someone asserts that pain isn't important, they're wrong, wrong, wrong, wrong, wrong. Pain is important, it keeps people from functioning, it reduces the quality of life for some people, and it costs big bucks in disability payments. I do believe in some alternative treatments - but when someone tells me that "Pain medication for your sore back? Not so much" (as in, not so important) they've obviously never tweaked their back, resulting in a herniated disk. Or the sore back that is actually kidney involvement...

Our system needs to be rebuilt from the bottom. Healthcare needs to be available to everyone. The current system of people with non-emergent conditions being forced to go to the ER if they're uninsured sucks. People even get turned away from insta-cares (aka doc-in-the-boxes) if they're uninsured, even if they have cash.

theoakman says

Elliemae, the only reason your pain meds cost so much is because the government makes them. In a free society, your pain meds would cost the same as tylenol. Trust me…I’m a chemist. There’s nothing magical about your pain meds that make them more expensive. This is a classic case of the government breaking your leg and then giving you a crutch. Once they supply you with the crutch, they somehow convinced you that you wouldn’t be walking without them.

Oh, right, that's why generics cost less than 20% of name brand drugs -- because the government makes the name brand ones!

I'm fully supportive of the rights of pharmaceutical companies to make money on their investments, but this argument is pure and utter bullshit. Most medications are incredibly cheap to manufacture (with some exceptions, like vaccines). It's the huge amount of research needed to find new medications that is being paid for.

Your comment about elective surgery is amusing to me. Elective surgery is any surgery that isn’t emergent. For instance, if a patient needs his gallbladder removed and is in horrible pain & distress, this is probably elective because it can be scheduled for a future time. Breast reduction surgery is usually elective too, even though the woman may suffer horrible back pain, deformity and skin ulcers.

Yes, when I said 'elective' I was referring to what normal, rational people call 'elective' procedures, not what the medical industry would refer to as 'elective'. Sure, you could CHOOSE not to have that brain tumor removed, after all...

Perhaps I should have used the term 'not medically necessary'. I'm all for a free market in nose jobs.

Cancer drugs are not essential. In fact, they literally kill you. You’d be surprised at how many people wish they didn’t get cancer treatment. If you think water boarding is bad…try chemo…

I'm sure I would be 'surprised' by how many people 'wish' they didn't get cancer treatment. I know I would personally rather have a tumor-induced aneurysm than chemo!

Cancer treatment is harsh and invasive because, frankly, we don't have any better options. You can die a slow and painful death from the cancer, or you can take the treatments, and maybe suffer. If you're lucky you might get cured.

Kevin - I agree with you on many points. But, for purely entertainment reasons, do you think that the ideal medical system should pay for botched plastic surgery. As in, Michael Jackson? And, of course, I have to wonder if they'll give him the perfect face in his casket that he longed for all his life. He's the classic case of Body Dysmorphic Disorder, as is Jocelyn Wildenstein (the cat woman).

I think that, to create the ideal medical system, we need to start from scratch. And (here's a unique idea), ask the medical providers about how they'd fix the system. I know that I have my ideas. Imagine asking a doctor how to best treat his patients - I'm sure that paperwork for billing (charting sucks!), dealing with pre-authorizations, arguing with case managers... and getting back to actual medical treatment rather than cramming in as many patients as possible in a day would be a huge part of that picture.

I would be happy if I never again had to tell someone that they're not eligible for treatment because of a lack of insurance - and that they'll have to wait a couple of years for Medicare. If they can hang on that long, they might have a chance.

I was in an argument last week over the cost of drugs, and anyone who defends the rigging of the American market always puts the cart before the horse. Drug companies charge as much as they can. Period. Its got nothing to do with recouping the cost of R&D. Often the drug was "discovered" during the search for something else. They may pour billions of unsuccessful $ into hair loss pills or breast enhancement cremes but that's only because the payoff is there. They would do it anyway. Better to let 100 kids die than waste money where there is no market. I can accept that. But what I can't accept is the way we're cajoled into paying more than our fair share.

They charge what the market will bear. Its just so infuriating we put up with it. We don't have to take this.

There is a typical "conservative" response to the government doing anything other than bombing brown people: "We can't do that! We will fail! It won't work because at least one person will steal/take advantage or die!"

I have great health care. My wife's a teacher/state worker. However, for the first 10 years of our lives we either had no insurance or paid $600-1000/month for phone tags and preventative care. I mean preventative in the sense that they prevented giving us any healthcare. When I broke my ankle I had to beg for an xray. The doctor told me to "ice it for 2 weeks" and then "ice it for another 2 weeks" .

All-in-all this is another ploy to get an employer expense off the books of the corporations and back on the backs of the underclass where it belongs. They used to pay us enough to take care of ourselves. Then came insurance where we are all basically spreading the costs around, borrowing from a younger generation. Now they're balking on health care, after abandoning pensions/retirement.

I'd say we're all about 30 years away from being employees of the federal government, and we'll be hired out to corporations needing work.

knewbetter says

There is a typical “conservative” response to the government doing anything other than bombing brown people: “We can’t do that! We will fail! It won’t work because at least one person will steal/take advantage or die!”

How can we view any of your other statements as rational after reading this? You just called nearly half the population a bunch of genocidal racists. *sigh*

Kevin says

Oh, right, that’s why generics cost less than 20% of name brand drugs — because the government makes the name brand ones!

I’m fully supportive of the rights of pharmaceutical companies to make money on their investments, but this argument is pure and utter bullshit. Most medications are incredibly cheap to manufacture (with some exceptions, like vaccines). It’s the huge amount of research needed to find new medications that is being paid for.

That's where you are COMPLETELY off base. It's not the research that is the major cost burden. It's the half a billion dollar hoop the FDA forces you to jump through to get it approved. Consequently, they were forced to enact Orphan Drug legislation for drugs used to treat ailments that only affected a small amount of people. Lets face it, no one will spend half a billion dollars to treat a thousand people. Somehow, we manage to not kill anyone with those drugs despite the fact that we don't have the 500 billion dollar hoop to jump through. R&D does cost money to develop drugs. It's a fraction of what it costs to get it past the FDA, who are a bunch of lunatic morons.

Elliemae, I completely disagree on pain. I went 4 years waking up not remembering what it felt like to be without pain. I messed up both my knees. My back always hurts. I had severe plantar fasciitis for 4 years which prevented me from standing for extended periods of time for nearly 2 years. You have the right to purchase treatment. Not the right to treatment. And you certainly do not have the right to have the government force others to pay for your treatment, especially if you have money of your own. For the truly poor and disabled, fine create a small safety net. For middle class Americans? Hell friggin no.

"The government makes medicine? That’s funny, because I thought it was pharmaceutical companies. Are we still talking about America?"
Do me a favor. Stuff it...I didn't say the government makes medicine. I said they make it expensive.

knewbetter says

All-in-all this is another ploy to get an employer expense off the books of the corporations and back on the backs of the underclass where it belongs. They used to pay us enough to take care of ourselves. Then came insurance where we are all basically spreading the costs around, borrowing from a younger generation. Now they’re balking on health care, after abandoning pensions/retirement.
I’d say we’re all about 30 years away from being employees of the federal government, and we’ll be hired out to corporations needing work.

I don't see it that way. Employers should not be our gateway to health care. That reduces our individual independence and allows employers to work you longer hours and pile on more work. You lose your leverage if / when a job becomes unreasonable.

Where are you going to go? Gonna leave your job? Go into business for yourself? Go ahead - what will you do about health coverage?

No matter which way we go with reform - a public system or a reworking of our private one - I'd like to see health care become a more accessible, individual thing. No grouping according to whom you work for or what affiliations you have. No denial of coverage just because a health insurer can't make a profit on you.

I want to work and save all my life, so that I can spend it all on medical expenses in the last year before I die. Doctors are worse than lawyers.

</blockquote>
How can we view any of your other statements as rational after reading this? You just called nearly half the population a bunch of genocidal racists. *sigh*
Well, its not my fault they're genocidal racists. I wasn't really commenting on their willingness to kill people, but their cowardice to try and fix anything. We spend enough money on health care in this country to cover everyone. I don't think we have a right to tell a doctor how much money he/she can charge, but why should a drug company be able to tell the government of the United States it can't comparatively shop around?
I was self-employed for 10 years and had to purchase my own insurance. I've also climbed poles and done very physical work with broken bones and torn tendons because I was afraid of losing my job/work. What really took the cake for me was when my HMO pulled out of my state, right in the beginning of my wife's pregnancy. The new HMO who took over considered "it" a pre-existing condition. My daughter was under-weight, so she must therefore be premature, and therefore 2 weeks early and therefore yadayada you owe us $10,513.00. It only took 2 years and about 300 hours to fix this little glitch.

On the Sidelines says

I want to work and save all my life, so that I can spend it all on medical expenses in the last year before I die.

A free enterprise system gives you that choice.
A socialized system writes you off as a goner. Too expensive to fix. You know, like Obama’s white devil grandma who he doesn’t miss at all.
The latest and greatest life-saving treatments will always cost a fortune — more than anybody is willing to spend on little old YOU. But wouldn’t you rather have the option anyway?

Man, I can't wait until we have "socialized medicine" so that people like you can be written off, then.

The "plan" Obama posted on his campaign website (so far as I know, this still represents what he wants) does not require adults to get health insurance if they don't want to. (The Hillary plan did, but that's history.) Obama's plan requires employers to provide it for employees, and parents to provide it for their children, and the government to make it available to self-employed adults who want it--but it does not require adults to get it if they don't want it. If you're employed by someone else, it has to be offered to you, but I suppose you could turn that down (along with your salary, pension and whatever other benefits your employer offers).

Smokers and overweight people save us money by dying sooner. We should be encouraging the use of corn and tobacco amongst our elderly. Maybe give them tax breaks for smoking a pack/day?

Or we can just euthanize them. They're had to get into the car, but if you throw in a Bingo card they'll jump in after it. :)

OTS asks:
"Do you think California earthquake insurance should cost the same as Minnesota earthquake insurance?"

Hell yes I do! The entire US is one be fault zone. California's faults occur more often, thereby releasing the tension. The largest earthquake that hit the US was in New Madrid, MO.
http://en.wikipedia.org/wiki/New_Madrid_Earthquake

Quote: The zone remains active today. In recent decades minor earthquakes have continued.[7] New forecasts estimate a 7 to 10 percent chance, in the next 50 years, of a repeat of a major earthquake like those that occurred in 1811-1812, which likely had magnitudes of between 7.5 and 8.0. There is a 25 to 40 percent chance, in a 50-year time span, of a magnitude 6.0 or greater earthquake.[8] Understanding of this earthquake zone is growing slowly in comparison to awareness of the San Andreas fault.

Earthquake preparedness
The situation is more precarious than it was in 1811. The area is more densely populated, and many buildings have no earthquake resistant construction.

Active research in the region continues, with a goal of defining the risk of future earthquakes. A few emergency funds for earthquake victims have been founded. Measures are also being ordered to mitigate any natural disaster resulting from an earthquake; thus in the construction of dams, bridges, and highways, earthquake safety is particularly being taken into account.

Obviously, I went off on a tangent. But - the perception that earthquake insurance should be cheaper in Minnesota or Missouri or New York can be compared ot the perception that pre-existing health conditions mean that insurance rates should be higher.

Pre-existing conditions can also mean that the subject has been accessing healthcare - and that there are no silent conditions that haven't been diagnosed because the subject feels healthy. Someone with medications for high blood pressure can be healthier than someone with hbp who isn't aware, isn't being treated, and is at risk for stroke/heart attack.

Term life insurance policies are different issues altogether. The insurance company makes its money by charging based on a person's life expectancy and buy-in during the life of the policy. If a person buys the insurance at age 30, their premiums are lower than are someone at age 50 because the company makes MORE money on a 30 year old over the years.

Healthcare is different. Many seniors aren't that sick. Many die without costing the system huge amounts of money. But they paid in the same amount while they worked, and pay Medicare for the part B premium at a cost of $100 per month plus co-pays & deductibles. Should their costs be less because they use less? Nah.

Yea - but a minor earthquake hitting Minnesota can cause more damage than one hitting SoCal. Home in MN are often built with bricks or other earthquake unfriendly materials. They're not built to the same earthquake standards that Calif homes are. If a large quake were to hit a populous area with aging infrastructure, it could cause massive amounts of damage. A minor hurricane hitting Calif would cause huge amounts of damage because homes aren't built to hurricane standards. Just sayin'

The way that an insurere builds enough margin into its models is to charge huge rates - and make money hand over fist by denying coverage if at all possible.

chrisborden says

I’d love to see Obama try to force me into getting health insurance when I can barely afford my rent, being way over 50 and highly unemployable. BTW, I take full responsibility for my perfect health (good genes and supreme discipline) and do not intend to live my “rust years” a slave to any medical system, nor do I live in constant fear of “what-ifs”. I remain uninsured now because I refuse to pay hundreds a month for virtually NOTHING in coverage save for a $3000 deductible. I’m willing to die rather than see my retirement and personal savings go to paying doctor bills. Call me a fool, but that’s how I see things. I refuse to be a slave to doctors and corrupt politicians, including Obama. I did not vote for him. The man does not know what is good for me. In fact, his parading of his supposed superior intellect disgusts me.

So what happens if you get hit by a car tomorrow? Should we just let you die in the street?

On the Sidelines says

Q: What keeps you from starting a cut-rate bureaucracy-free insurance company?
A: Government red tape

Bwahahahaha, clearly you've never worked at any large company. Bureaucracy is inherent in any large organization.

Smaller insurers would cost less, but they're still *insurers*. INSURANCE does not make ANY sense for a basic necessity. Do you buy "food" insurance? No! The whole system is just broken.

At the end of the day, either the government will ration your health care and give the best treatment to the people IT likes, or the marketplace will ration your health care based on willingness to pay. Clearly, unless you are a member of the political elite, you will be better off under the latter system.

Under which medical system does this happen? Please, tell me in which country health care is 'rationed'. Not even the communists do this.

That would be a country that's on the sidelines. bwahahahaha!

On the Sidelines says

Under a market-based system you are free to self-insure. For instance, you can drop collision and comprehensive on your car insurance, but if you wreck your vehicle nobody is going to buy you a new one.

Now you're not even making any sense. Automobile insurance IS for catastrophic, unpredictable events.

Regular medical check ups are neither catastrophic, nor unpredictable. They are a basic necessity of life.

On the Sidelines says

And you somehow believe government is more efficient than private businesses in this respect?

They're pretty much the same, in my experience. The biggest difference is that I get to vote a new "CEO" in every 4 years with the government, and there are members of "the board" who actually hold dissenting opinions.

Yes, I trust the U.S. government more than I trust most fortune 500 companies, though that really isn't saying much.

On the Sidelines says

The UK and Canada have been in the news for this. They have long waiting lists and are known to deny treatment to the elderly.

Both statements which are equally true of the U.S. system, and neither of which is "rationing". I've yet to meet a single Canadian or British person (and I know a lot of them) who prefers the U.S. system.

Of course, that still doesn't mean that we actually have to have a Canadian or British style system. There are dozens of other models that all work better than the U.S. system. I'm somewhat partial to the Swiss system; it's cheap, works well, and everybody is covered. Physicians actually compete for non-emergency treatment!

The last time I took one of my kids to the emergency room I had to wait 4 hours to see a doctor. That seems like a long wait to me. My dad is still waiting for his oxygen tank. Don't even get me started on the 'pre-existing condition' bullshit.

I have some of the best health care you can get. Blue Cross Blue Shield. At least I'm told its good. Its such a pain to get into the doctor I just wait until I'm really sick.

The last time I was in an ER I had my arm twisted behind my back (broken in two places), and couldn't physically pull my wallet out of my pants to get my HMO card out of my wallet. I was in so much pain I could only talk in short gasps, and they still wouldn't admit me until I could get them a credit card. I sat in a waiting room for 45 minutes while the muscles in my arm started to contract, and rub the ends of the broken bones together then-SNAP! the sharp edges of the bone started cutting through tissue. My arm was swelling and I was starting to shake when a doctor happened to walk through, and just started screaming at me, asking me "WHAT THE F**K ARE YOU DOING IN THE WAITING ROOM!".

I'm sure this is an isolated incident, and hospital staff is not trained to respond in this manner. Please bare with us.

Kevin say:
My dad is still waiting for his oxygen tank.

Please take your father to the MD and have 02 sats (saturation rate) taken. If it's over 89% he doesn't qualify. If his sats drop at night, ask for the possibilty of a sleep study or a 24-hour sat for intermittent needs. If you have any questions, call a Medical Equipment company and ask them who to call. Tell them your problem.

Oxygen does not need pre-approval or such, just the qualifying sats (if we're talking Medicare or Medicare HMO). If he is not yet on Medicare, call the number on his insurance card and ask for their help. This shouldn't be difficult.

From what I've seen, the Swiss system seems to work. People who read alot on the interweb think that they're experts on the system. The current system is horribly broken - four hours in an ER is nothing in some cities. Insurances are set up to deny benefits.

I'm fighting with my insurance because they recommended a surgical procedure and I went with non-invasive treatment that costs less and has zero recovery time required. The insurance case manager told me that my choice was stupid and that they may not pay. I saved them thousands, but her ego won't allow her to understand that her choices aren't the best for everyone.

Some Guy says

Um, no - you said, “Elliemae, the only reason your pain meds cost so much is because the government makes them.”

If you don’t know how to construct a sentence to convey your meaning, that is not my fault.

Rofl, you can interpret it either way. I suggest you use the one that makes sense instead of using the one that allows you to act like a jerk.

theoakman says

Some Guy says

Um, no - you said, “Elliemae, the only reason your pain meds cost so much is because the government makes them.”
If you don’t know how to construct a sentence to convey your meaning, that is not my fault.

Rofl, you can interpret it either way. I suggest you use the one that makes sense instead of using the one that allows you to act like a jerk.

Actually, initially I thought that you meant that you believe the govt makes drugs - then I thought you meant that they make them "expensive" and didn't add that word. But it can be taken either way.

Altho Patrick is working on this forum, editing is a bit tedious and you have to remanufacture stuff. But I have a different problem, not Patrick's doing at all. I type very fast and somehow keep hitting some key, not sure which one, that goes "back" and I lose what I was doing. It happens in email too. I've tried to duplicate it when I'm watching, but can't. So I'll have an intelligent post (or, what I believe to be intelligent) only to find that I've dumped it into the interweb void. If I re-post, it certainly isn't as thoughtful or well-explained.

If you two are going to fight, I'm not gonna let you play together anymore!

Now, get inside and get momma another drink. And mow the yard, momma hasn't seen her car for awhile. (Note: until I was sixteen, I thought my name was "get beer.")

FYI
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There's no such thing as a hippo oath, other than that that possibly determines who gets to lay in the mud first.

Everyone is NOT seen, no-matter-what. Where ever from which you receive your information is incorrect.

You state that "if you want to be a doc you agree to serving 4 days per month in the Free Health Clinic ran by the local county you practise (sic) in." You are proposing socialism if you are proposing free clinics.

Bap33 says

insurance only gaurentees payment — so the only winner is the provider.

How does the insurer not win?

Bap33 says

The answer is really simple. End all forms of insurance and go cash-for-service or barter or doc can take payments intrest free. And if you want to be a doc you agree to serving 4 days per month in the Free Health Clinic ran by the local county you practise in.

That just makes the problem worse, because now the hospital can charge you whatever you want and you're stuck with the bill. What happens if I'm hit by a car and I'm unconscious and they rush me to an emergency room? How do you know that I'm OK accepting the charges?Bap33 says

socialism sucks

Yeah, but what's that got to do with health care? Do you believe that Switzerland is a more 'socialist' country than the US (and if you answer 'yes', I'm going to assume that you've never been there or even read the wikipedia article on the country)? Because they also have a 'public option'.

There is no doubt in my mind that TRULY free markets work. Health care, however, is NOT a free market, and it's not possible for it to be. In much the same way, there's no free market in municipal utilities or roads due to physical constraints.

It isn't a free market unless there is competition. Free market does not simply mean 'government isn't involved', and anyone who believes that it does knows absolutely nothing about economics.

Not sure why this in HOUSING.

But medical industry in USA is run by INSURANCE COMPANIES now. They are determining factor on fees and treatment. Not doctors and not government.

All hyothetical re-jiggerings of the system seem to avoid touching the INSURANCE PARASITES.

It does seem fascinating to me that Americans are perfectly OK with government-run when it comes to Coast Guard rescuing your butt from the ocean, or handling nuclear weapons, or any number of other quite CRITICAL functions. But when you talk about doing the same thing with medicine, they have a seemingly visceral programmed reaction against it. It's an arbitrary & capricious choice in my opinion. If many decades ago we had gone with a Medical Corps or outsourced our military needs to the Swiss, or hell turned Social Security over to JP Morgan, then there would be an entrenched position around THOSE choices that would say "it's ALWAYS been this way, this is the right way, don't even think about changing it!"

drfelle,

You are basically saying that poor people are lazy and require the threat of "no health insurance" over their head, or else they will not work. Good to know what you think the real reason is.

But I think Patrick himself had much better and different explanation which went more along the lines of "we can exploit workers harder when they cannot get health insurance elsewhere".