SkyDekker 1,465
lawrocket[Reply]Where do you see the balance for the US? Notice I asked for the US, not for a lawyer/doctor couple.
As an aside, held these views well before I married a doctor. My viewpoint hasn't changed much in that time.
In the relationship between open access, affordability and quality, I'll go "War Games" here and say the only winning move is not to play. Here's what I mean:
Health care is indeed a public concern. However, when government policy steps in, it necessarily means that whomever is running it gets his or her values placed on top. This limits individual choice. Look at places where, in the name of equity, people are not allowed to seek healthcare outside of the system unless they go overseas.
I personally have a belief that I should have health care when I want it for all the quality I can afford. There are plastic surgeons out there doing some amazing and life saving procedures in burn centers. On the other hand, there are plastic surgeons out there who can do some things with my penis for the right price. Maybe I can increase to five inches for a few grand, but it's not worth it to me.
There it goes. Is there a doctor out there that will give me a physical for 100 dollars - no insurance? When I get a sinus infection, is there are doctor that will see me for $60 cash and give me a script for some antibiotics? Can I pay cash for a generic? Where can I get the best price?
Yes, I think that taking third parties out of payment can greatly increase the efficiency. It will result in massive layoffs as back office billing personnel are laid off, as well as adjusters for insurance and other parts of the private and governmental billing staffs are canned. Which is where we would have been but for third party involvement.
Look at the Mayo Clinic. They stopped taking Medicare and Medicaid patients because the government reimbursement was so low. Government thinks it can lower "cost" by lowering "price."
The easiest way, I think, to lower the cost and price of health care is to either: (1) decrease demand; or (2) increase supply. Also, it can be lowered by decreasing the transaction cost. By making healthcare a cash-centered system, several things would happen: (1) it would dramatically decrease transaction costs by making the care payable at point-of-service (not payment via intermediaries); (2) it would make patients add a cost/utility analysis to the treatment, thereby staying away from the doctor for the stubbed toe or case of the sniffles; (3) doctors would be in competition with each other, since patients are locked in to seeing doctors within the provider panel of the insurance, so service and price options would be more varied; (4) insurance would be there to cover high value losses (like homeowners insurance, auto insurance, etc); and (5) health insurance would, of course, increase in price for those with chronic illness, etc.
This would, I think, give access on demand and leave options available for people. It allows the individual the choice of how they want the care to be. Want to go to the pediatrician with the gleaming office and indoor playground even though it will cost an extra $30 per visit? Or would you prefer the gal with the low-frills office, low cost and long waiting list? Or would you instead go to the gal who will see your child right now for low cost and do basic checkups but is a nurse practitioner and won't be providing your child with any procedures?
Under central planning, those options aren't there. By eliminating central planning, individual choices create niches to be filled. In a sense, it leaves options open for everyone.
Yes, there are problems with it. I understand that the system would leave many people very unhappy. But it's where I would balance things.
Thanks for the reply!
How does this deal with those who cannot afford care? If you identify health care as a public concern, but want it free of government policy, how will those who fall through the cracks get any care?
And why would any doctor want to deal with those who cannot pay instantly?
Does society as a whole have any obligation to look after the health of all of those in society? Or is one truly only responsible for oneself?
mpohl 1
For one, spare me your sob story about hard-ship and arrogance that your forefathers encountered. But not you yourself. Save THAT posturing for the court-room...
For the other, Uwe Reinhardt is a well-respected political economists as far as economics of health care are concerned. I am sure you know how to google...don't disappoint me!
As you reading up on the subject and getting a modicum of knowledge. No, there is not THE perfect system in the world. But by all accounts, the US has the worst among its peers...so, it can only improve from here!
For the other, Uwe Reinhardt is a well-respected political economists as far as economics of health care are concerned. I am sure you know how to google...don't disappoint me!
As you reading up on the subject and getting a modicum of knowledge. No, there is not THE perfect system in the world. But by all accounts, the US has the worst among its peers...so, it can only improve from here!
lawrocket[...]
The reason my forefathers left Europe is because of the flippant and ill-considered arrogance of the Europeans. Telling people to "shut up" and be "re-educated" is certainly the way of doing things by our friends across the Pond. Seriously - "shut up and listen" is about as insulting as one can get. You are not that important.
[...]
Then inform me. How cab a health care system be inexpensive, high quality and available on demand? There hasn't been a system yet that hasn't compromised at least one.
So tell me about it. Educate me, professor. Baron of Knowledge.
JerryBaumchen 1,468
Hi mpohl,
Quotethe US has the worst among its peers
I, personally, have a quite good system.
My mother is 91 yrs old and is on another system.
I have a POA from her and pay all of her bills for her.
A couple of days ago I received a letter from her health care system. I could not make any sense out of it, it appeared to be a bill for $824.
But it did say to call 1-800-xxx-xxxx for Customer Service.
On Monday I called, waited about 15 minutes for someone to come on the line. He could not speak adequate English and finally admitted that English was his 2nd language.
Yesterday I called again, waited about another 15 minutes and got someone and they actually could speak English. However, they could not understand anything about the letter, which I had very carefully & slowly explained what it did say. I finally asked for a supervisor, waited about 10 minutes, spent about 25 minutes with her and she finally admitted that she was in sales and would transfer me to Customer Service ( and here I thought I had actually called Customer Service
). Another 10 minute wait, and after about another 25 minutes ( I have a timer on my phone ) I was told that I should merely disregard the letter and not concern myself with it.
That is private health care in America today.
If anyone thinks that private health care in America is good, my advice is: Do not get sick.
JerryBaumchen
[Reply]How does this deal with those who cannot afford care? If you identify health care as a public concern, but want it free of government policy, how will those who fall through the cracks get any care?
Good question for which there is no good answer. As I indicated, the older or sicker one is, the more it will cost. It may become something that is quite troublesome unless someone does some planning. Of course, that planning hasn't been done for decades so people who relied on medicare and the like would be hosed.
I think, though, that people fall through the cracks in every system. Having health care paid by someone else is no goof if you can't access it.
[Reply]And why would any doctor want to deal with those who cannot pay instantly?
Yet they are forced to do so. Meidcare pays a pittance and takes 60-90 days to pay it. So my system may pay them a pittance, but now.
[Reply]Does society as a whole have any obligation to look after the health of all of those in society? Or is one truly only responsible for oneself?
I think (and minds can differ) that the individual is where responsibility starts. Once another takes responsibility for me I become indentured. And once I become responsible for another I become indentured.
I am responsible for me. Unless I've paid someone else to take responsibility for a risk (insurance).
There is no right answer. I know it. There's what I believe is best for me. It's not best for everybody. Not by a long shot. Thing is - I admit that. And I would actually like to see others do the same.
But I am glad that you're being conversational with this. [Beer]
My wife is hotter than your wife.
Then don't have the government help. Governments can't build a footbridge over a creek for under $10 million, anymore.
I do picture government healthcare like government bridge building. It'll be delayed, it'll cost factors more than promised, and then maintenance will be put aside until disaster happens.
My wife is hotter than your wife.