patrick.net

That I don't have the government choosing which procedures, devices and drugs should be covered by my insurance company (or the government insurance plan). I like the fact it is driven by the free market and if a plan does not stack up, my company can choose to shop elsewhere for a more comprehensive plan. I don't like the 5000 things that are broken with the current system though. At some point things like QALYs need to be used to keep costs in check though ... it really is a matter of time. I just want everything for less (the California mentality)!

People with a "private medicine=PARADISE" mentality clearly haven't dealt with HMO in much depth. Many companies have a limited number of equally sucky choices. When you get right down to it the private companies want PROFIT for least amount of work. Thus like my brother who had to pound on a lot of doors to get them to deal with hernia in any vaguely timely manner the care can be quite slow. They don't view the alien protruding from your belly as an urgent thing until it's eating other crewmembers, please let's patiently wait a few months just use your hand to hold your intestines m'kay? And what do you do about it? Next year you get to pick door #2 and find they suck as bad. They also want to avoid doing a bunch of referrals to specialists and tests when possible, so like my niece who spent 7 YEARS being incorrectly diagnosed before finding out she had Crohn's disease, yeah that can suck pretty bad too. I'm not saying either system is any great shakes but I find the reflexive reaction "government medicine = bureacracy & negligent death galore" often coming from people who have relatively shallow experiences with any kind of medicine. It's usually people who don't like government to start with and are TERRIFIED it might go wrong on them in their hour of need. Despite the fact that they trust the government to rescue them floating in the ocean (Coast Guard) or to handle nuclear weapons on a daily basis. And they are contrasting with what? With a government program they have no personal experience with either? With make-believe comparison to DMV? I dunno. This issue is so pre-loaded with unexamined gut reactions it's impossible to debate like grownups.

Agreed it is hard to debate with most people as healthcare quickly becomes personal and most people have very personal experiences. I do like to point out that the government is already controlling 1/2 of our health care "system" (hard to call our healthcare an actual system which all parts functioning together) and things aren't going that great thus far. Now this isn't to say that with more focus and vast changes to the way the insurance industry is run things couldn't be improved, but I just find it hard to believe that government control will improve the ways things are run. I believe that the government should have a lot more standards and enforcement to make the system much more transparent then the mess we have today. And, yes HMO's have major issues. When I speak of private insurance I'm guess I think of a PPO model where I can see whoever I want. I do tend to pay more for the option of the PPO when I have a choice of insurance companies from my work. I do realize this isn't the view of private insurance most people have and many Americans are left without these options.

American health care system slogan Even though we are "health care provider" we cannot insure you because you are sick.

Has any one looked at how much medical insurance and malpractice suites impacted the cost of healthcare in the US? Unlike many other countries, it is very easy to sue a doctor in the states.

Tenpoundbass says

d3 says

Has any one looked at how much medical insurance and malpractice suites impacted the cost of healthcare in the US? Unlike many other countries, it is very easy to sue a doctor in the states.

Yawn, you mean it’s the only industry to where you can be held accountable for being a Hack?

I am all for people’s right to sue, including doctors. Suing doctors however has become the latest and greatest get rich quick scheme that every sleazy lawyer is trying to profit off of. Too many people who get sick or hurt themselves are looking for someone else to blame because they are too selfish to see there own follies. Although there are some valid reasons for suing a doctor, my guess is 90% of the suits are simply a blame game that a lawyer and "victim" are trying to profit off of. I strongly believe this is one of the reasons it costs 3x more to get treatment in the US than any other country in the world. Would you rather treatment cost 1/3 the price or would you rather be able to sue the doctor whenever you do not feel like you got the "best" treatment. Personally I think there is a middle ground, ie setting stricter requirements for being able to collect from malpractice., ie gross negligence

I have a relative who works in the healthcare insurance defense industry. Although she does see a number of cases where the docs really did screw up and injure someone due to negligence, much too often the cases are just ridiculous. My favorite was the case she had were a convicted felon suing a hospital from prison. Not only did the felon not have a lawyer, after he learned in jail how he could sue the hospital, the case was a complete joke. In the end the case was thrown out, but not until the insurance company had to spend a good chunk on legal fees. My opinion is that there should be a separate court system similar to bankruptcy to handle these cases, or at least some way to filter them out before they even reach the point where an insurer needs to respond. I'm still not sure this adds that much unneeded (some cases are valid) waste to the system though. Another nice legal waste the money spent on hospitals suing the government and the government suing back to invalid changes or unpaid charges. Ironically, a single payer system (or universal coverage, or mandated coverage, or insurance exchanges or whatever they come up with) does nothing to address any of these issues.

Tenpoundbass says

Fuck the Doctors and the stethoscope they rode in on. I’ll worry about their welfare when Doctor owned hospitals(which I’d wager contribute to a greater hemorrhage of money from the hcs than all of the lawsuits combined) are a thing of archaic thinking. It’s essentially Doctors writing their own checks.

Ah yes, I know one of those. The richest person I know...as in 42 years old and worth millions and millions of dollars... I was curious how a doctor could get that rich.

You do not have to be a doctor to have millions of dollars. Are you sure he made all of his money from being a doctor??? or are you just speculating? You can be the dumbest person in the world and win the Lotto or have money passed down to you and be a millionaire. Yes there are doctors who do make a LOT of money, however most doctors do not make a fortune. There are a lot of primary care doctors who are very good at what they do who can barely afford to stay in business. Also if you invest $100ks and give up 8+ years of your life in school you should be making big money. Else why become a doctor? Why not become a lawyer, in some states you don't even need a degree to pass the bar exam.

d3 says

You do not have to be a doctor to have millions of dollars. Are you sure he made all of his money from being a doctor??? or are you just speculating? You can be the dumbest person in the world and win the Lotto or have money passed down to you and be a millionaire. Yes there are doctors who do make a LOT of money, however most doctors do not make a fortune. There are a lot of primary care doctors who are very good at what they do who can barely afford to stay in business. Also if you invest $100ks and give up 8+ years of your life in school you should be making big money. Else why become a doctor? Why not become a lawyer, in some states you don’t even need a degree to pass the bar exam.

yes. He's married to one of my closest friends. He graduated with more than 100k in student loans and no money. He mentioned he got lucky and his second job was for a hospital that went private, making him part owner. 10 years later he has millions with a dozen homes around the world. I am talking crazy money.

This doucebag thinks you are preaching to the choir here and this is not news. I do not know why citizens are content with matters as they stand. I perceive that many of them are focussed on inconsequentials like who is in the Oval Office. Even in your own post your ire about a President "hires & fires corporate CEO’s and illegally re-writes private business contracts to his heart’s content." seems a rather curious inclusion in the parade of transgressions. Maybe it went like this: Prez: I feel terrible about this Chuck, but I think it's best you resign Chuck: Well OK then, I'll fax my resignation over. It always strikes me as funny how people suddenly become all prickly about "contract law" because some CEO is tossed overboard. Did anyone actually research how these "hiring & firing" occur and thus are violations of some particular code that can be identified? Or is it more informal and perfectly LEGAL asking someone to resign like I've laid out above. Do you know? I don't. But you've decided to be incensed about that point and not some other....just 'cause I dunno you heard it on a radio show? The citizens do not object to being referred to as "consumers" in 99% of discourse and even use the word themselves. They are being herded into permanent debt slavery and do nothing about it. Why? The system is actually efficient at maintaining status quo?

Whoa there guys!...baaaa!...baaaa!...excuse me, I had some lawn clippings stuck in my mouth; don't you know that us 'PEASANTS' can now be rounded up and shot thanks to the Patriot Act. That kind of thinking isn't allowed when you can qualify for a leased BMW and a nice tract home with granite counter tops and 55 inch flat screens for all rooms in the hills provided your FICO score is over 800 and your income is well north of six figures. Some people prefer to be a nice little sheepies...baaaa! baaaa! BTW, has anyone seen my Zoloft and Ambien? It's time for my daily dose:)

I'm not even sure as to the point of your post. Who here on this board would accuse you of pessimism porn? I agree that things are not as good as they appear and there is still downside risk to all sorts of things. I assume that's a common belief amongst many here. Are you saying we don't believe these things? This board was one of the earliest in the calls against the housing bubble. If you are trying to argue that the US is "finished" then I must ask, In relation to whom? Every other industrialized country is also running the printing press as fast as they can. There is one good thing about fiat currency and that is it's value is all relative to the values of other fiat currencies. If all the fiat currencies have the sane problems (which they do) then it's the same as them having no problems at all. Sure there will be some arbitrage with regards to the time frames during which this all happens but I believe the rest of the world is doomed as much as we are.

Bwahah! Constitutional purity & your high-school civics dead long before you were born. Little late to that party! Federal Reserve Act 1913, The "interstate commerce" rationale, CIA & NSA acting inside US, the War on Some Drugs, Patriot Act, a chain of events way predate Obama. Thanks for the shotgun blast rant that was a hoot. Ranting about CEO firing *now* strikes me funny like a person complaining whole family murdered but ENRAGED cat was injured too.

d3, You asked if anyone had looked into the cost impact of malpractice claims. Indeed, your fellow poster Kevin already has, and this is what he found: >>You’re still wrong. Try digesting this one: http://www.ncbi.nlm.nih.gov/pubmed/16136632 (in 2001 the figure was 0.46% for the combined cost of defending, insuring, and settling malpractice claims; less than a quarter of that was awarded to victims. At best, completely banning lawsuits is going to reduce medical care costs by less than 1%. Awesome. In short, the notion that malpractice claims are a big burden on the health care system is wrong. At best, it is just misguided to claim otherwise, and at worst it is a decoy issue intended to distract from the real problems, and/or give doctors immunity against lawsuits which they should not have.

justme says

d3, You asked if anyone had looked into the cost impact of malpractice claims. Indeed, your fellow poster Kevin already has, and this is what he found: >>You’re still wrong. Try digesting this one: http://www.ncbi.nlm.nih.gov/pubmed/16136632 (in 2001 the figure was 0.46% for the combined cost of defending, insuring, and settling malpractice claims; less than a quarter of that was awarded to victims. At best, completely banning lawsuits is going to reduce medical care costs by less than 1%. Awesome. In short, the notion that malpractice claims are a big burden on the health care system is wrong. At best, it is just misguided to claim otherwise, and at worst it is a decoy issue intended to distract from the real problems, and/or give doctors immunity against lawsuits which they should not have.

1% of an annual 2.4 trillion spend on healthcare would be 24 billion dollars annually. 1% of heathcare is a good chunk. Even it if was only half were talking 12 billion a year. Guess by today's standards that just isn't that much. Edited - bad math ...

TPB, I just noticed you posted a certificate from a ESRI GIS User's Conference to start this thread. What the hey ?? I fail to see how this relates to your point in any way (I must say, and not to offend, but I often fail to make heads or tails out of your posts). I do enjoy seeing that my industry (I work in this area) is 'on the map' (tee hee). I thought it would be a cold day in ... anyway, the award you post has nothing to do with Health care - it was for an ATLAS OF ICELAND. But I suppose a 'huzzah' to you for creating a busy thread with 400+ comments. Oh ... and I repeat, I thought this was a housing forum.

Vicente says

This doucebag thinks you are preaching to the choir here and this is not news. [..]The citizens do not object to being referred to as “consumers” in 99% of discourse and even use the word themselves. They are being herded into permanent debt slavery and do nothing about it.

I do! I object! I object! Just stated so on another thread. I AM NOT A CONSUMER, I am a CITIZEN. You know what I was saying in 2004? It's '1984', 20 years late.

Cigna PPO new slogan: "We insure healthy people only, so our ROI goes to top and hence our stockholders make money."..... Send me more ...We are having a competition where we judge slogans of health insurance companies in America.

classic struggle between have's and have not's....but for the first time i am with the have's or else we all will become have not's. I never understood why health care is limited resource. i thought a limited resource is something which can be traced to something which cannot be produced and is contant (water, some minerals, land..etc. how come health care became limited resource ? why is free market broken here. its just a f**ing service like another specialized service except that supply has been artificially contrained. there are only two inputs : doctors and equipment ..which one is a limited resource ? and why

>>were talking 12 billion a year. Right, and about 25% of that goes to victims of malpractice, as determined by a jury in a court of law. So what is the problem? You can argue that lawyers and insurance companies take too much of the cake, and I would agree, but that does not mean that we should give doctors immunity. We could cover a 0.46% higher fraction of the population if there was no malpractice, and no malpractice suits. But would you want to be treated by a doctor that has no financial motivation in preventing errors, and you having no recourse to get compensated for your loss due to errors? I certainly would not. In summary: Ragging on malpractise lawsuits as being the reason for unaffordable healthcare is factually wrong, dishonest, and is used by right-wingers as a distraction from the real issues.

renter for ever_san jose says

classic struggle between have’s and have not’s….but for the first time i am with the have’s or else we all will become have not’s. I never understood why health care is limited resource. i thought a limited resource is something which can be traced to something which cannot be produced and is contant (water, some minerals, land..etc. how come health care became limited resource ? why is free market broken here. its just a f**ing service like another specialized service except that supply has been artificially contrained. there are only two inputs : doctors and equipment ..which one is a limited resource ? and why

Typical fear mongering that if Govt takes over health care, we will all become have nots....But I bet you don't mind police and other jobs being done by governments including such critical things as responding to a fire alarm. Even when critical jobs like airport security were transferred to TSA, a federal agency, after 9/11 people like you were keeping their tails inside their asses....now when times comes to health care suddenly it becomes a struggle between haves and have nots....Shame on you...Come out of your little frigging shell and think of other people too...

everybody is concentrating on thier own agenda and benefit. Democrats want to ration health care and get votes from the have not's. Republicans want to ensure that the rich keep thier power to buy health care with money ( which will dissappear soon). Nobody is trying to find the right solution to fix health care because right solution doesn't motivate either party. Right solution : find out why health care SERVICE has become so expensive and market forces are not working to bring down the cost. Once the bottlenecks are identified , try to remove them. Current bottlenecks : 1) insurance keeps buys insulated from prices 2) Doctors lobby keeps supply of doctors limited 3) drug and insurance lobby influence govt and keep thier monopoly. eg: you cannot buy drugs from outside the country..etc

final word : You cannot solve a real famine by rationing but by trying to find a way to produce more food.

renter for ever_san jose says

Doctors lobby keeps supply of doctors limited

Why cannot we have H1B for doctors ? I agree that having more hospitals and doctors will definitely bring down the prices...but that assumes everyone pays from their pocket....Here we are talking about insurance based health care...Even if you sneeze you need to go through your insurance ....And "for profit" insurance has no motive to really look after poor sick people...

Bap33 : your point makes sense but we are talking about services here, which are provided by humans biengs to human biengs and thus makes it independent of breeding unless the rate of breeding is too fast compared to the time it takes to train for the services.

in a free market, a human service can never become a bottleneck..example : prostitution will never be a limited resource in a free market unless govt intervenes.

Why cannot we have H1B for doctors ? They do! part of exchange programs. Not to mention some doctors who intern here, move back home, along with their patients.. I read how India and Thailand health care is growing with Medical Tourism. So keeping a limited supply of doctors doesnt work. Its much cheaper and easier to go overseas. Do a search on india thailand medical tourism Its extremely difficult to get in to medical profession isn US ..period. For engineer's , the end customer ( companies who hire) determine what qualifications they need. In Medicine, the end customer (hospital or patient) DON'T decide what qualifies a doctor, its the freaking AMA. AMA keeps the barrier of entry very high by putting too much red tape and licencing requirements. Its similar to a communist govt trying to control everything. AMA (doctors lobby) is very powerful which contraints the supply of medical schools and entry into them. It also has one of the most cubersome and lengthy licensing requirements in the world. thier main goal is to keep the supply of doctors low to boost the salaries of existing doctors..similar to unions. I wish there was some lobby like that for software engineers so that i could get 300k for my work.

renter for ever_san jose says

Why cannot we have H1B for doctors ? They do! part of exchange programs. Not to mention some doctors who intern here, move back home, along with their patients.. I read how India and Thailand health care is growing with Medical Tourism. So keeping a limited supply of doctors doesnt work. Its much cheaper and easier to go overseas. Do a search on india thailand medical tourism Its extremely difficult to get in to medical profession isn US ..period. For engineer’s , the end customer ( companies who hire) determine what qualifications they need. In Medicine, the end customer (hospital or patient) DON’T decide what qualifies a doctor, its the freaking AMA. AMA keeps the barrier of entry very high by putting too much red tape and licencing requirements. Its similar to a communist govt trying to control everything. AMA (doctors lobby) is very powerful which contraints the supply of medical schools and entry into them. It also has one of the most cubersome and lengthy licensing requirements in the world. thier main goal is to keep the supply of doctors low to boost the salaries of existing doctors..similar to unions. I wish there was some lobby like that for software engineers so that i could get 300k for my work.

Very well said renter...I knew AMA was making sure that H1Bs do not start taking their jobs...But you summarized the situation succinctly.

renter for ever_san jose says

in a free market, a human service can never become a bottleneck..example : prostitution will never be a limited resource in a free market unless govt intervenes.

I have seen this in Europe...I have no idea how America became such a Nanny state. But america had to struggle and to come to terms with their violent (towards native americans) racist (towards blacks) past... I guess while trying to do that they became excessively religious and excessively money minded...My friend who visited me from overseas was joking that only time he sees americans smiling is when they are receiving money...I tried to counteract his point but had to agree to some extent...

renter for ever_san jose says

2) Doctors lobby keeps supply of doctors limited

Heh, Where did you get that from? 1. From my understanding doctors have little lobbying power. It is the insurance companies who have the power and can determine how much a doctor will get paid for someone. 2. one of the main reason for the shortage of primary doctors is because a lot of them are leaving the feild to make more money doing something else. Fewer and fewer people want to waste 8+ years of there life to only get paid the scraps left for them from the insurance companies. I know of atleast 3 doctors who have left there practes within the last few years because health insurance companies squized out any hopes of them becoming profitable again.

The landlord has a right to collect from you untill the bank formerly starts foreclosure proceedings. If you stop paying him before that he can sue you BUT BE CAREFULL! He probably won't tell you if they've foreclosed on the property, and may still try to collect from you. In that instance, he's taking money that belongs to the bank, and they can still expect you to pay them for the money you gave to the landlord! I'd call the bank to find out what's up.

This is just another of the wonderful benefits of renting: the owner gets foreclosed on and your lease and agreement with him become null and void (here in California). You have to continue paying or risk your credit rating and if the bank forecloses you might be sent packing and be forced to look for another place. Not much of a problem if you barely have two nickels to rub together and don't own much furniture etc. But a real problem if you are renting a large house and you have books and art~work along with your furniture.

Some people need to check their facts more carefully before speaking out. No one gets to be a doc in 8 years, the minimum is 11 years for a family practice doc. 4 years to a ba, 4 years of medical school, 3 years of residency. At least during residency you get paid more or less minimum wage. Most family practice docs make in the very, very low 100's. Not bad for racking up a debt of 200-400,000 dollars in tuition and giving up 11 years of your life. Many of our family practice friends joke they will make their last student loan payment with their first social security check. Since the top of the food chain docs make maybe 400k in today's market if they work lots of hours I would be very interested in finding out how someone becomes a serious multimillionaire in less than 10 years practicing medicine. The numbers just don't add. Total malpractice PAYOUTS are less than 1% of medical costs. NOT total malpractice costs. Premiums and defensive medicine (a very real expense but impossible to quantify) add a considerable amount. That being said it is probably no more than 2-4% of total healthcare costs. So malpractice isn't the PRIMARY driving factor in health care costs, but represents a real expense nevertheless. The real cost of malpractice is in the rapidly approaching crises in the specialties that most affected by malpractice rates. Ob's for one are rapidly becoming an extinct species. My wife is an Ob. We are overseas and she will never practice in the states again. We know many Ob's who are going out of the country or leaving medicine altogether. Want your baby delivered, call your lawyer to do it. The AMA has nothing at all to do with the supply of doc's. Medical schools, residencies, USMLE testing, state medical boards all have their own independent accrediting boards and have no association with the AMA at all. To the people who hold this idea the training of docs is being limited by some type of grand unspecified conspiracy, you really need to look into the cost and effort involved in expanding a medical school or a residency program. It's not like a law school where you can throw a couple extra chairs in the back of the room. Despite the extremely high cost, 4 new medical schools have opened in the last 4 years, bringing the total to 131. The first students of these new schools will become practicing docs in 2019. H1B docs? Sure why not. It won't change the cost of medical care one cent. Insurance companies set the reimbursement rates. The only effect will be each Doc will see less patients. The number of patients seen will still be the same, no one will be less sick if there are more docs around. The rates paid by the insurance companies will be the same. Net effect on costs - Zero. Anyone who feels the training level of american docs is excessive to their needs or who desires to save money on their health care is free to go anywhere in the world they would like to get their health care.

"Las Vegas and parts of Florida and California will see 90 percent or more of their loans underwater by 2011". Last night I was watching "R.E. Virgins" and the woman buying the house was concerned b/c the house was only 90% of what she REALLY wanted. The Realtard reorted (to the camera) that as far as the housing market goes, 90% is as good as it gets. Well guess what folks, 90% underwater is as good as it gets.

"Anyone who feels the training level of american docs is excessive to their needs or who desires to save money on their health care is free to go anywhere in the world they would like to get their health care" Why should we go elsewhere in the world ? why not here in US ? why i am not free to get prescription from a less trained doc in US. why am i not able to get a doc who has only highschool + 5 years medical school in US.I know many countries do that and accredit them so that patients make the decicion wheather to use them or go to someone with more training.WHY CAN"T A CONSUMER HAVE THAT FREEDOM ? I thought freedom is so important in this country. what happened to "freedom to choose" We make life and death decisions everyday. do you think people are not smart enough to choose the doctor with the right training based on what they want the treatment for? I want to go to a 10+ years trained surgeon for my heart surgery but not for my common cold.

H1B docs? Sure why not. It won’t change the cost of medical care one cent. Insurance companies set the reimbursement rates. The only effect will be each Doc will see less patients. The number of patients seen will still be the same, no one will be less sick if there are more docs around. The rates paid by the insurance companies will be the same. Net effect on costs - Zero. This is hilarious ...its like saying " H1b's won't affect cost of software development because its the software companies which set the salaries and cost of software products" Economics 101 : more labor supply reduces labor cost.

renter for ever_san jose says

in a free market, a human service can never become a bottleneck..example : prostitution will never be a limited resource in a free market unless govt intervenes.

No, prostitution will not become legal in US. Sarcasm Things that will be legal are those that add greatest contribution to GDP and economy. Economists at Wall street firms have identified that prostitution is not that beneficial to economy as perversion is. If people can get their sexual needs fulfilled, think of millions of jobs lost in perversion industry also known as porn. Goldman Sucks has estimated that the total size of porn industry is around 10 billion dollars, this includes porn on internet and porn video industry in Calipornia near north of LA. Also, even though ban on prostitution will be enforced rigidly, govt will let nudie bars flourish. Cops will be posted in nudie bars to enforce the law that the patrons cannot touch the dancers. All these actions will make sure that perversion industry flourishes and Goldman sucks and JPM make billions. Abby Joseph Cohen, the evil incarnate of Goldman sucks, has again predicted a bull market in porn industry. end of Sarcasm

renter for ever_san jose says

“Anyone who feels the training level of american docs is excessive to their needs or who desires to save money on their health care is free to go anywhere in the world they would like to get their health care” Why should we go elsewhere in the world ? why not here in US ? why i am not free to get prescription from a less trained doc in US. why am i not able to get a doc who has only highschool + 5 years medical school in US.I know many countries do that and accredit them so that patients make the decicion wheather to use them or go to someone with more training.WHY CAN”T A CONSUMER HAVE THAT FREEDOM ? I thought freedom is so important in this country. what happened to “freedom to choose” We make life and death decisions everyday. do you think people are not smart enough to choose the doctor with the right training based on what they want the treatment for? I want to go to a 10+ years trained surgeon for my heart surgery but not for my common cold.

You can. They are called nurse practitioners. Granted they have to be working under the supervision of an MD, but they can prescribe drugs and treat basic illnesses.

Then there is the issue of incentive. what incentive does a patient have in going to a nurse when the copay is the same whether he goes to a nurse or to a M.D ..nothing. the co-pay is the same. looks like health care is broken from both supply and demand side.