The KGB Oracle

Healthcare - For Sinij

Posted By: Kaotic

Healthcare - For Sinij - 01/09/12 06:16 PM

Discuss.
Posted By: Sini

Re: Healthcare - For Sinij - 04/24/12 06:17 PM

Debt Collector Is Faulted for Tough Tactics in Hospitals

Quote:
Hospital patients waiting in the emergency room or convalescing after surgery could find themselves confronted by an unexpected visitor: a debt collector at bedside.

Accretive debt-collection employees, calling themselves “financial counselors,” are instructed by the upper management ranks to stall patients entering the emergency room until they have agreed to pay a prior balance, according to the documents.

Patients with outstanding balances are closely tracked by Accretive staff members, who list them on what employees refer to as “stop lists,” internal documents show. In March 2011, doctors at Fairview complained that such strong-arm tactics were discouraging patients from seeking life-saving treatments.
Posted By: Wolfgang

Re: Healthcare - For Sinij - 04/24/12 10:29 PM

WOW that's wrong. As I mentioned in another post, I had to have emergency surgery and racked up a $10,000 bill. They knew I didn't have Insurance. I spent a week in the hospital, they DID NOT send someone to my bedside asking WHEN I was going to pay. They did come in and offer medicaid, but since I had a job and made decent money they likely would not have paid much on it anyway. So I declined the medicaid and paid for it myself. I'm sure there's some horror stories out there, those things are going to happen because people are fucking stupid. Don't use that as a way to claim the Government taking over healthcare is any better, because it's not. As I mentioned in the other post, there are many ways to cut healthcare cost that doesn't Involve taxing more or more Government involvement.
Posted By: Mithus

Re: Healthcare - For Sinij - 04/24/12 11:14 PM

I have changed my mind on health care issue, I think government involvement would not be any better like you said.

but out curiosity, Wolfgang, like you said before you had to pay 10.000 for the problem that you had, but if you had an heart attack and had to pay for a bypass cirurgy that costs like $112,000, what would you do?
Posted By: Cheerio

Re: Healthcare - For Sinij - 04/25/12 02:18 AM

hmm you could sell assets, you could make payments, you could raid your retirement if you have one.

if you have been legally employed you have been paying disability insurance, which will gove some sort of income.

i for example pay extra insurance so i am totally covered even if something happens at home. it aint cheap, but im not as young.

i think when youre young you can gamble that you will stay fairly healthy. if you want to mitigate risk a catastrophic insurance policy is cheaper than a cell phone payment every month.

remember: "failure to plan ahead on your part does not constitute an emergency on my part".
Posted By: Cheerio

Re: Healthcare - For Sinij - 04/25/12 02:29 AM

Originally Posted By: Kaotic
Discuss.
Originally Posted By: sinij
Debt Collector Is Faulted for Tough Tactics in Hospitals

Quote:
Hospital patients waiting in the emergency room or convalescing after surgery could find themselves confronted by an unexpected visitor: a debt collector at bedside.

Accretive debt-collection employees, calling themselves “financial counselors,” are instructed by the upper management ranks to stall patients entering the emergency room until they have agreed to pay a prior balance, according to the documents.

Patients with outstanding balances are closely tracked by Accretive staff members, who list them on what employees refer to as “stop lists,” internal documents show. In March 2011, doctors at Fairview complained that such strong-arm tactics were discouraging patients from seeking life-saving treatments.


damn dude, did you even read your own article? the company was hired by the hospital, number one. number two, what they did was probably illegal, number three, how are these hospitals supposed to survive all this unpaid debt? in my shithole town the county hospital closed- went broke- and the catholic hospital that was left had to reduce services to survive. those filthy christians were mad at losing so much money i guess. what nerve!
anyway i would rather see the hospitals sue their patients who dont oay and take all their stuff.

by the way, i have teenage students who pwe 100s of hours of community service and 10,000s in restitution who must pay those off- you just make one payment at a time
Posted By: Sini

Re: Healthcare - For Sinij - 04/26/12 02:35 AM

Originally Posted By: Cheerio
remember: "failure to plan ahead on your part does not constitute an emergency on my part".


So what is your plan for getting cancer, losing your job and getting dropped from your insurance and/or reaching lifetime max?
Posted By: Donkleaps

Re: Healthcare - For Sinij - 04/26/12 04:06 AM

I would say dying.
Posted By: RedKGB

Re: Healthcare - For Sinij - 04/26/12 04:21 AM

Originally Posted By: sinij
Originally Posted By: Cheerio
remember: "failure to plan ahead on your part does not constitute an emergency on my part".


So what is your plan for getting cancer, losing your job and getting dropped from your insurance and/or reaching lifetime max?


Enjoy the time you/I have left. Everyone dies, no one gets out of life alive. It is not some one else's job to ensure I make it to 70. And before you make a mean come back, I have buried one child allready, and watched one barely survive, and anthoer go thru surgey for 3 hours to live. I had no insurance at the time, I made less then 1k a month during this period. Was it hard, hell yes, did I pay back every dime, yes, 20 dollars every 2 weeks.

Sinj, you keep coming back with what if's, I have lived thru your what ifs. Millions to billions of others have allso. It is not the goverments job to take care of us from the cradle to the grave.

And yes Sinj, I still love you, and enjoy talking with you.
Posted By: Sini

Re: Healthcare - For Sinij - 04/26/12 05:24 PM

Red, it seems that you went through a lot of hardships in your life, and I am sorry you had to go through that. I can't imagine kind person like you wishing any of it on others, but that is how your posts reads.

"It is not the government's job" conservative line of thinking is used to justify undermining main function of our government - that is combine society's resources and then distribute them in most effective way. How can an individual engage in "Life, Liberty and the pursuit of Happiness" if they are sick, starving and have no way out of their predicaments?

Health care is a fundamental human need and existing system that does not guarantee basic health care to every member of society makes it impossible to achieve or exercise your freedoms. Fundamental Human Needs. How can one advance career, or start your own business, or invent next technological breakthrough if one has to be concerned with preexisting conditions, breaks in coverage and all other evils this system inflicts on us?

The system we have right now is barbaric. It is nether consumer-choice oriented nor market-driven, nether 'greater overall good' nor best individual outcome-based. US health care costs more than anywhere in the world and delivers worst results. Doesn't matter what ideological side of this debate you happen to subscribe to - one thing you cannot deny, existing system is simply does not work.
Posted By: Sini

Re: Healthcare - For Sinij - 04/26/12 05:41 PM

Originally Posted By: Donkleaps
I would say dying.


This is not a choice most people willing to go with, and fundamental reason why market-driven (not that our existing system is anywhere close to being market-driven) health care system could not exist even in principle.

Consumer choice - a process where a product is not consumed at a high price point due to its perceived value not matching cost and resulting in downward pressure on price - simply does not exist for majority of people because "no thanks, dying is more cost effective for me" is not a choice many people would make.
Posted By: Derid

Re: Healthcare - For Sinij - 04/26/12 06:36 PM

"""It is not the government's job" conservative line of thinking is used to justify undermining main function of our government - that is combine society's resources and then distribute them in most effective way. How can an individual engage in "Life, Liberty and the pursuit of Happiness" if they are sick, starving and have no way out of their predicaments?""

This really points out where we diverge.

It is absolutely not a governments job to take my resources and distribute them to others in a manner it finds politically expedient.

Any top down society like you describe is nothing but tyranny, now matter how enlightened or just the motives of the people seeking to implement it.

No matter how you spin it, in the end all that type of system equates to is the people at the top using brute force to take from some and give to others based on their own judgements of value, which, history tells us, usually has nothing to do with any type of objective value.

It just cant work. Do you not understand or acknowledge at all, the types of and magnitude of problems that occur when peoples choices are taken from them and put in the hands of the ruling elite? Which is what, btw, govt officials become in the types of society you describe. Even the much touted by Socialists Nordic countries have been rotting from within, and they have massive resource exports per capita to prop up their fallacy.

I really wish you would read Human Action, and Socialism sometime. It would open your eyes, or at least help you evolve better arguments.
Posted By: RedKGB

Re: Healthcare - For Sinij - 04/26/12 08:06 PM

Sinj, your right, I do not wish that on any one. But what I do wish on them is personal responsbility. I used an example from my life to show that, no matter how bad it is, there is a way foward that does not invole the goverment.

For your statement that what I posted is a consevative line of thinking. I am far from a conseravtive. How ever I do view it as a personal reponsbility. I also do not view it as the goverments job to redistubute resources. I view there job as given us a vacum tobe anything we wish tobe. Life: the right to be alive, Liberty: the right to succed or fail, Pursuit of Happiness: to engage your self in the caarer you desire regradless of the career your mother or father had.

Now as my views pertain to AHCA(obamacare). I agree with regulating insurnace companies not to drop due to preexsiting conditions, nor a life time cap, nor am I against the offspring staying on thier parents insurance till 26.
What I am against is the force to buy insurnce for just being alive.
What I wish was included was the ability to buy insurance over state lines, a single payer option, and a tax break for those that have cadallic policys.

Not sure I have said it before, so let me say it now, I do respect your postion. I enjoy the ability to have an open debate where both sides respect each other and where the other person comes from.
Posted By: Helemoto

Re: Healthcare - For Sinij - 04/26/12 10:45 PM

Millions of people a year getting cured and living longer.
People not piled up in the streets dieing or dead.
This is for sure the most barbaric system to infest the known world.
Posted By: Sini

Re: Healthcare - For Sinij - 04/26/12 11:49 PM

Originally Posted By: Helemoto
Millions of people a year getting cured and living longer.


Life expectancy

Australia 81.6 yr
Canada 81.2 yr
Sweden 80.9 yr
Netherlands 79.4 yr
...
US 78.1 yr

Healthcare Costs:

Sweden (social, 9% GDP)
Canada ( social, 9% GDP )
Netherlands (state mandated purchase of private health insurance, 8% GDP)
Australia ( social, 6% GDP)
USA (private, 15%+ GDP)

Swedish healthcare costs or $3319 per person
Canadian healthcare costs or $3899 per person
US healthcare costs or $7291 per person
Posted By: Kaotic

Re: Healthcare - For Sinij - 04/27/12 12:19 AM

The first problem with your data Sinij, as we've repeatedly shown, is that the U.S. carries the burden for medical discovery and advancement for virtually the entire world.
Cost differential explained.

The second problem is a function of our wealth as a nation. We are the 1% of the world (to put it in classist terms you can identify with), and we're fat and lazy as a consequence. We abuse our bodies to no end and we consume some really horrible stuff in the name of convenience. These are things that most other countries on the planet cannot afford, and that, for the time being, we are free to do. In what fantasy do you believe that you'll be allowed to continue to make poor health choices once the government is responsible for your healthcare?
Life expectancy explained.

Here's what I really cannot understand. If there are countries on this planet who govern like you want, to whom you point as an example and who you place on a socialist pedestal, all while decrying our draconian immigration policies; why not immigrate to one of those countries? Why insist on changing the only country on the planet like ours to be like all the others you hold in such high esteem?
Posted By: Sini

Re: Healthcare - For Sinij - 04/27/12 02:06 AM

Originally Posted By: Kaotic
The first problem with your data Sinij


There isn't any problems with my data, but feel free to come up with alternative numbers that contradict my assertions.

Quote:
as we've repeatedly shown, is that the U.S. carries the burden for medical discovery and advancement for virtually the entire world.


You repeatedly speculated. Shown would imply that you had a shred of evidence or anything other than a lot of vigorous hand waving.

Quote:
The second problem is a function of our wealth as a nation.


All cost figures are also show as % of GDP, they are still astronomically high.


Quote:
US exceptionalism hurfdurf


Countries I compared US to are First-World, with similar quality of life, personal income and so on. You'd have a case if I compared to Zimbabwe and Somalia, but I didn't.

Quote:
Here's what I really cannot understand. If there are countries on this planet who govern like you want, to whom you point as an example and who you place on a socialist pedestal, all while decrying our draconian immigration policies; why not immigrate to one of those countries? Why insist on changing the only country on the planet like ours to be like all the others you hold in such high esteem?


If our ancestors didn't like to live under British colonial yoke they should have just left, right?
Posted By: Derid

Re: Healthcare - For Sinij - 04/27/12 02:27 AM

http://www.oecd.org/country/0,3731,en_33873108_33873886_1_1_1_1_1,00.html

See the article on high US health costs.

The US gets a lot of crap done, medical wise per capita.

Also, we pay more for drugs. US and Japan are the best for things like Cancer. This ties in with the discovery and advancement. So to does the high ratio of advanced equipment per capita. I believe Japan is #1, saw it on a documentary about their financial crises related to health costs and an aging population. Dietary and cultural health trends also play a part.

Oh, we also pay more for our publicly administrated health apparatus. This will include bodies like the CDC and FDA.

One aspect of the higher costs, which is not specifically addressed here - but is obvious to anyone with a grounding in economics is the wide physical distribution of the population over a large area, whereas smaller countries with smaller populations will not have nearly the same overhead because the serviced population will typically be more concentrated.

Another aspect, is taking into account the psuedo-socialism that we already have in place. This comes in the form of regulations, insurance costs due to an inefficient litigation system, and other assorted misc inefficiencies but thats all found in different papers I am feeling too lazy to dig back up.

Something else that isnt mentioned in the article, but is easy obtainable with just a little bit of self motivation is comparison of waiting lists. The USA doesnt have them for most types of treatment, as opposed to most other countries. As a consequence, some popular treatments cost more if you do not want to wait. Since most people have insurance, they opt not to wait.
Posted By: Sini

Re: Healthcare - For Sinij - 04/27/12 03:51 AM

Derid, now take your arguments and try to apply them to any countries I have compared US to. Litigation, even more socialistic systems, regulation, decentralized population... all of it Australia, Canada, Sweden, Netherlands have plenty. I am not convinced that you could demonstrate significant difference between US and countries I have listed, but by all means try again.

Life expectancy (and the rest of metrics, like child mortality or chronic diseases are equally bad) demonstrates that whatever US health care system is doing, so that would include having higher ratio of advanced equipment per capita, is clearly nor working. So what that we have more expensive medical machines - they are clearly not helping, just look at the outcomes.
Posted By: Sini

Re: Healthcare - For Sinij - 04/27/12 03:59 AM

Originally Posted By: Derid

See the article on high US health costs.


This one?

WHY IS HEALTH SPENDING IN THE UNITED STATES SO HIGH? (PDF)

It pretty much agrees with what I said. Higher costs, worse or equal outcomes.

Especially look at Table 4 - administration is 274%, physicians and specialist expenses - 238%... Over-over-over paying by orders of magnitude and have nothing to show for it.
Posted By: Derid

Re: Healthcare - For Sinij - 04/27/12 04:21 AM

Life expectancy is not a good indicator of the health system past a certain point. Or at least of the quality of treatment. Just looking at smoking alone, dietary considerations aside - the US has like 2% more of the population smoking than Sweden. Considering smokers live considerably less long on average, 2% more smokers probably in of itself accounts for several months of the average life expectancy differential. There is also plenty of evidence that child mortality is not tied to the medical system as such, environmental factors, cultural factors, etc play into it. You cannot make a 1:1 comparison between quality of health care and these metrics you mention.

To get a picture of the actual quality, you have to look at data for life expectancy in the face of difficult, yet still treatable disease. Rates of longevity and survival for Heart Surgery, Cancers, trauma injury, etc. As well as effectiveness and comfort of treatments like joint replacements and therapy for the chronic diseases you mention. Speaking of chronic diseases, many of those are also not correlated with medical quality, at least their contraction.

http://newswithnumbers.com/2009/10/28/cancer-survival-revisited/

There is some data on cancel survival rates, as you can see - Socialist countries lag far behind the USA, sometimes to an astonishing degree.

Lifestyle is a cultural matter, not a medical one.

Also, in your partial rebuttal I am sure you were thinking of Canada - but Canada has but a small fraction of the overall population, and far far fewer advanced treatment centers.

Regarding litigation/regulation, the different structure of their system and different litigation environment give that aspect a different impact. A lack of lawsuits in the case of publicly owned industry often actually equates to a lack of recourse. I am not sure to what degree that is the case here, I have heard stories but they are just stories. Getting in depth English language info about the inner working of other countries can be difficult at times.

So, I actually do not have to try again - re-examine the links you attempted to make. Upon closer inspection, you will find your counters faulty.

Though I will say one thing in favor of the Swedes that works in their favor and they did right - by and large, their health system is actually administered at the local level, not the federal level. The amount of local control is unprecedented, and goes far above and beyond anything we have seen in the USA. This would certainly help improve the efficiency of the system, as local control improves accountability and responsiveness over Federal management.

Posted By: Kaotic

Re: Healthcare - For Sinij - 04/27/12 08:07 PM

Originally Posted By: Sinij
If our ancestors didn't like to live under British colonial yoke they should have just left, right?
Um, they did...
Posted By: RedKGB

Re: Healthcare - For Sinij - 04/27/12 08:11 PM

Originally Posted By: Kaotic
Originally Posted By: Sinij
If our ancestors didn't like to live under British colonial yoke they should have just left, right?
Um, they did...


Glad I was not the only one that noticed it.

But then again I am looking at it as the colonies left and not one person at a time.
Posted By: Wolfgang

Re: Healthcare - For Sinij - 04/27/12 08:18 PM

The debt has outgrown the GDP through the first quarter. So should we keep spending more, so we can ensure we go in the direction of third world status?

The buffet tax would raise $50 billion, how in the hell is that going to help with Trillions of debt? It won't, even Obama's budget spent more, again how in the fuck can you reduce the debt while your still spending DESPITE bringing on more revenue?


Quote:
If our ancestors didn't like to live under British colonial yoke they should have just left, right?

They did... what rock have you been living under? I think this stupid question says all we need to know about you!
Posted By: Cheerio

Re: Healthcare - For Sinij - 04/29/12 06:27 PM

Oh boy, where to start. How about some numbers:

http://reason.com/archives/2008/06/17/accidents-murders-preemies-fat

So the numbers in there match up, but they also have a few other nuggets. We are too fat, have too many teen pregnancies, too many murders, etc. I'm not sure that a single payer system would solve any of that OR make it cheaper. For counter example please examine other government monopolies like mail, electricity, etc

To be honest, this is all beside the point. The point is that I should be responsible for my own decisions. Health care is not a human right just because some UN commission decided it was! How is it moral to take from me the fruit of my own labor and give it to someone else? That is NOT the social contract, my friend.

In an earlier post, a paranoid fantasy was acted out where I was hypothetically stripped of coverage, lost my job, etc. In this case, I would still get treatment under the current system, I would just be in debt for life with no option to repay- just like Uncle Sam!

Allow me to outline another paranoid fantasy that I fear much more AND feel is more deadly: Sinij's Fantasy Island, one payersystem is enacted. Everyone lines up TSA style at the local clinic for their MRI, chest x-ray, whatever. Upon finding a lump in my neck (or my kid's), I am kicked upstairs for Secondary Evaluation. The lump is diagnosed 1.5 years later as lymphoma, the medical review panel calculates the odds of survival, cost of treatment, and future earnings and decides that it is not worth treating. We are given pain and mood drugs, and referred to a hospice situation. In this scenario, there is one medical provider, and everyone has access to my files. Once a decision has been made, it can be appealed (another few years) but not treated further. I have no options!

I prefer to take my chances with treatment and debt that to have some death panel judging me and mine.

My question is, if Sarah Palin is so dumb, why can she see this and all you hippies can't?
Posted By: Sini

Re: Healthcare - For Sinij - 04/29/12 07:30 PM

Originally Posted By: Wolfgang
Quote:
If our ancestors didn't like to live under British colonial yoke they should have just left, right?

They did... what rock have you been living under? I think this stupid question says all we need to know about you!


No, they didn't leave, they had a nice civil war over cup of tea and agreed to have quite a bit of changes done to how things are run.

So in conclusion - fuck you, I am staying, how about you get your troglodyte ass the fuck out to your libertarian "small government" paradise in Somalia instead?
Posted By: RedKGB

Re: Healthcare - For Sinij - 04/29/12 10:45 PM

First off understanding the words posted: Civil War: a war between political factions or regions within the same country.

( US ) history the war fought from 1861 to 1865 between the North and the South, sparked off by Lincoln's election as president but with deep-rooted political and economic causes, exacerbated by the slavery issue. The advantages of the North in terms of population, finance, and communications brought about the South's eventual surrender at Appomattox

Now what occured against the Brits was a Revolutionary War: The war for American independence from Britain. The fighting began with the Battle of Lexington and Concord in 1775, and lasted through the Battle of Yorktown in 1781. General George Washington commanded the American forces, assisted by Ethan Allen, Benedict Arnold, Horatio Gates, John Paul Jones, and others. The leaders of the British included Charles Cornwallis, John Burgoyne, Thomas Gage, and William Howe, among others. The American cause was greatly aided by French ships and troops and by the presence of the French nobleman and soldier the Marquis de Lafayette. The Treaty of Paris in 1783 officially ended the war. ( See Battle of Bunker Hill and Battle of Saratoga.)


So now that we have cleared the difference from a civil war to a revolutionary war, lets look at anthoer example of your use of Somalia.
Somalia has no offical form of government, so there for it can not be used as an example.

So in conclusion you know have been showen the differences.
Posted By: Wolfgang

Re: Healthcare - For Sinij - 04/30/12 02:50 AM

Originally Posted By: sinij
Originally Posted By: Wolfgang
Quote:
If our ancestors didn't like to live under British colonial yoke they should have just left, right?

They did... what rock have you been living under? I think this stupid question says all we need to know about you!


No, they didn't leave, they had a nice civil war over cup of tea and agreed to have quite a bit of changes done to how things are run.

So in conclusion - fuck you, I am staying, how about you get your troglodyte ass the fuck out to your libertarian "small government" paradise in Somalia instead?


Your Ignorance is simply amazing.
Posted By: Sini

Re: Healthcare - For Sinij - 04/30/12 03:09 AM

Originally Posted By: RedKGB
So now that we have cleared the difference from a civil war to a revolutionary war


You are mistaken. Revolutionary war is by definition is a type of civil war. In my earlier post I did not specify, The Civil War, term usually reserved for North vs. South civil war, so you are not even technically correct in your point.

If you don't believe me, ask internet - Civil war, List of Civil Wars

Quote:
A civil war is a war between organized groups within the same nation state or republic,[1] or, less commonly, between two countries created from a formerly-united nation state.[2] The aim of one side may be to take control of the country or a region, to achieve independence for a region, or to change government policies.


Quote:
Somalia has no offical form of government, so there for it can not be used as an example.


How so? They 100% succeeded at deregulating everything and reducing government as much as possible. Plus since they have no government they also have no taxes. That is Libertarian Utopia through-and-through.
Posted By: Sini

Re: Healthcare - For Sinij - 04/30/12 03:17 AM

Originally Posted By: Wolfgang
Your Ignorance is simply amazing.


Did you completely abandoned any further attempts of intellectual pursuits and relegated yourself to comforts of intentional denial?
Posted By: Derid

Re: Healthcare - For Sinij - 04/30/12 04:02 AM


The USA "left" the British Empire. That much is true, the original comment may have been intended to solely include physical movement, but the way it was written was not technically consistent with that intent.

-

civil war
 
noun
a war between political factions or regions within the same country.

--------------


That is the reference.com

Now, do we consider a colony of an Empire a faction or region of the same country.

I will lean toward yes, that we could technically refer to the Revolutionary War as a civil war.

Now that those issues are settled, can we all stop getting heated over semantics please?

-----

Further aside, Sinij, the USA was in fact extremely libertarian for a very long time... and has never been anything like Somalia, so can you please stop using that reference - it really serves no purpose.
Posted By: Sini

Re: Healthcare - For Sinij - 04/30/12 03:43 PM

Originally Posted By: Derid
Now that those issues are settled, can we all stop getting heated over semantics please?


Derid, but someone is wrong on the internet, we have to correct them!

Quote:
Further aside, Sinij, the USA was in fact extremely libertarian for a very long time and has never been anything like Somalia


This is true, you could consider part of US history as libertarian and you can point to a number of similarities with present day Somalia - from mining company towns, to Pikertons, to large lawless areas (of wild west fame), to robber barons.

Quote:
so can you please stop using that reference - it really serves no purpose.


No I won't, not until libertarians clearly define limits to reduction of government and limits to deregulation as opposed to "more is better!" approach.

Still, this is clearly not a health care debate, how about we move it to appropriate thread?
Posted By: Wolfgang

Re: Healthcare - For Sinij - 04/30/12 09:58 PM

Originally Posted By: sinij
Originally Posted By: Wolfgang
Your Ignorance is simply amazing.


Did you completely abandoned any further attempts of intellectual pursuits and relegated yourself to comforts of intentional denial?


By the reply below I would say you have beaten me to it!
Quote:
No, they didn't leave, they had a nice civil war over cup of tea and agreed to have quite a bit of changes done to how things are run.

So in conclusion - fuck you, I am staying, how about you get your troglodyte ass the fuck out to your libertarian "small government" paradise in Somalia instead?
Posted By: Sini

Re: Healthcare - For Sinij - 04/30/12 10:05 PM

I just wanted to add that Wolfgang, I love and respect you as a person despite the fact of your questionable political convictions.

[thumbsup}
Posted By: Wolfgang

Re: Healthcare - For Sinij - 05/01/12 12:44 AM

Originally Posted By: sinij
I just wanted to add that Wolfgang, I love and respect you as a person despite the fact of your questionable political convictions.

[thumbsup}


Awww I love ME too Sinij. [yes]

I respect all views, If we all had the same views it would be a pretty fucking boring place!
Posted By: Sini

Re: Healthcare - For Sinij - 10/05/12 06:20 PM

Healthcare spending around the world, country by country

Quote:
The data shows that the US has the highest health spending in the world - equivalent to 17.9% of its gross domestic product (GDP), or $8,362 per person. And it's not all private - government spending is at $4,437 per person, only behind Luxembourg, Monaco and Norway


So to put it in perspective, US government share of healthcare spending is BIGGER than entire healthcare spending by countries with universal healthcare, like Canada.

Where are the outcomes?
Posted By: Derid

Re: Healthcare - For Sinij - 10/05/12 07:58 PM


You dont listen when things are explained to you, so why go through it again?

You only seem interested in latching on to correlations that support your pre-determined outcome, and show little interest in the metal rigor of understanding the underlying systems and how they interact.

A couple cherry picked numbers pulled from a system this large and complex mean nothing unless you understand the whys and hows.
Posted By: Sini

Re: Healthcare - For Sinij - 10/05/12 11:14 PM

Explain? Please, you wave hands in the air and ignore the facts.

Obscene, huge numbers of money US spends on healthcare isn't some correlation - it is The Problem.

Sorry MONEY SPENT ON HEALTHCARE isn't "couple cherry picked numbers" it is The Problem.

Why do I bother, you will still ignore elephant in the room because it doesn't pass your ideological purity test.
Posted By: Sini

Re: Healthcare - For Sinij - 10/05/12 11:15 PM

Originally Posted By: sinij
US government share of healthcare spending is BIGGER than entire healthcare spending by countries with universal healthcare
Posted By: Kaotic

Re: Healthcare - For Sinij - 10/06/12 12:06 AM

Originally Posted By: sinij
US government share of healthcare spending is BIGGER than entire healthcare spending by countries with universal healthcare


And even with that they still can't make shit work, and you want to give them more power and more money. Stupid is as stupid does...
Posted By: Sini

Re: Healthcare - For Sinij - 10/06/12 02:53 AM

No, I want to start doing what other countries that spend A LOT LESS on healthcare do and get similar or better results.
Posted By: Derid

Re: Healthcare - For Sinij - 10/06/12 03:40 AM

Originally Posted By: sinij
Explain? Please, you wave hands in the air and ignore the facts.

Obscene, huge numbers of money US spends on healthcare isn't some correlation - it is The Problem.

Sorry MONEY SPENT ON HEALTHCARE isn't "couple cherry picked numbers" it is The Problem.

Why do I bother, you will still ignore elephant in the room because it doesn't pass your ideological purity test.


I already laid out the facts, if you want go back and look again.

You are the one with the intellectual impenetrable bubble, I reminded you of a handful of the factors in other thread. Not retyping pages of explanations for you to ignore - like you are doing here. I am done being trolled, if you want me to spend time explaining things to you - I need to think you are actually interested in the discussion and not just loltrolling me into writing a page by tossing out a couple confrontational lines.
Posted By: Sini

Re: Healthcare - For Sinij - 10/06/12 02:20 PM

No Derid, your "pages of explanations" are grasping for the straws. Your arguments weren't convincing or relevant. For example, our discussion into how governments are funded and who is net exporter of energy was interesting, but it had very little to do with healthcare, where you can easily see that $/person costs are still higher and decouple whole thing from "things that artificially inflate size of GDP".

Just to sum them up, so you can be sure that I do read your posts and not just "loltrolling" - your arguments boil down to following: a) people are significantly less healthy in US b) US subsidizes healthcare for entire world c) US is so exceptional that you can't really compare GDPs.

None of these hold water.
Posted By: Derid

Re: Healthcare - For Sinij - 10/06/12 06:40 PM


/facepalm
Posted By: Sini

Re: Healthcare - For Sinij - 11/20/12 03:58 PM

----

Is healthcare a right or privilege?

It doesn’t really matter where you stand on this entirely artificial debate. Practicality of modern life is that health care has to be provided, and the only questions are how much, at what costs and with what outcome. Would you agree that providing health care to uninsured via emergency room visits is not cheap, not effective, and does not result in a good patient outcome?

Point #1: Right or privilege, it still has to be done.

Let also consider insured. Your typical insured health care consumer is not a rational market player, with a rare few exceptions consumption pattern is “all of it, all the time, at any cost”. In an individualistic society like US health care will be universally seen as a matter of self-preservation. In such environment pure market force acting via supply and demand cannot regulate the price. People will not turn away from cures or lifesaving treatments no matter what the cost is, so the ‘market’ forces will drive cost up only constrained by efficiency of extracting value from consumers. Ever-climbing cost of health insurance when some of these unconstrained costs get distributed to the insured population is a grim reminder of market system on-going failure.

For example, at this moment the only downward pressure on certain cancer treatments is an average net worth of a likely cancer patient. We see plenty of evidence of this -medically-related personal bankruptcy is still the leading category; even bankruptcies due to housing market collapse did not dethrone it.

Point #2: Health care demand is inelastic; as a result costs are contained only by ‘net worth’ calculations.

So what are actual sources of health care costs? Unsurprisingly end-of-life treatments come up the list, but so are emergency rooms. Administrative costs are obfuscated, but they greatly exceed stated industry average “profit margins” due to cost of doing business in addition to profit is creating unacceptable drag on the system. Still, with all of these costs it is clear that overall costs keep rising. This drives up price of coverage for everyone, cancer survivor and a healthy and fit 20-something looking for accidental coverage. With increasing wealth inequality and due to ‘net worth’ calculations more and more people are getting priced out of any and all coverage.

Point #3: Wealth inequality creates a situation where increased profit taking from well-off consumers makes pricing bottom out of the market a profitable and acceptable business decision.

------

Could a single-payer system work in US, and is it preferred alternative to existing system?

You mentioned few key concepts as your objections to single-payer – economies of scale and market price. I addressed market price with Point #2. Let us examine economies of scale.

Health care costs can be categorized in a following way – research and development, delivery of treatments, and manufacturing of pharmaceuticals and devices.

Delivery of treatment is a fixed cost, no matter if you amputating the leg with a rusty saw or delivering laser brain surgery you still have to pay for training, facility and personnel. Implements do change, but I put them into separate category.

Your argument then will have to be refined into R&D and/or manufacturing. At this point mass production is well-understood concept, so we can consider costs of treatment and devices as mostly recouping costs of R&D. To support this assertion we can look at a low cost of generics.

R&D, with US doing something close to 60% of worldwide, is where most of expenses occur. Some of it is publicly funded, but lots of it is private. Covering costs of private research, design and clinical tests is the main source of raising healthcare costs.

So where does this entire R&D budget goes? Well, as with any business decision, it goes toward developing treatments that are most profitable. Point #2 and #3 come heavily into play here.

Point #4: Health care costs, at least in private sector research and development, are not driven by improving patient outcomes or quality of life but by maximizing profits.

So what does Point #4 means? It means that development of new treatments is not prioritized according to reducing suffering or finding new cures for obscure condition. This means that a lot, if not most, of private R&D is spent on gaining marginal improvements for blockbuster profit-generators. From the point of “greater good of a society” -this is not an effective use of our collective resources. Last cancer treatment was good enough; we do not need another one, one that we as a society can no longer afford and are not capable of refusing on individual level. (See Point #2).

With Point #4 in mind, single-payer will definitely reduce private investment into R&D. I demonstrated that this is not money well-spent, but rather money that can generate return. Single-payer will not produce shortages; nobody will take “will not sell” decision, they will simply take a loss and reduce future R&D.

Do you know why single-payer countries can negotiate lower prices? Well, partially because of ‘collective’ aspect of it, but mostly because of a threat of revoking patents and manufacturing generics. For example, if you refuse to sell a drug to Canada, they have a right to revoke your patent and manufacture generics right away.

This is exactly why we need single-payer in US. To rationally distribute health care. To put controls on run-away healthcare spending. To address Points 1-4.
Posted By: Derid

Re: Healthcare - For Sinij - 11/20/12 04:10 PM

Yeah I will get around to addressing this in other thread.

Its somewhat difficult because your knowledge base regarding economics makes explaining things simply difficult since I cannot take anything for granted.

I do find it extremely scary though, that this type of thinking is so widespread.
Posted By: Sini

Re: Healthcare - For Sinij - 11/20/12 05:06 PM

If only that were true. In actuality I am quite conversant with economics, including understanding many of the shortcomings of its predictive power, oversimplifications and ungrounded assumptions used in economic modeling, and it inability to assert far-reaching effects outside of its narrow transactional scope.

Especially its tendency to focus on local wealth creation and tendency to ignore the fact that causality in the real world is highly networked, and simplistic answers/observations are seldom useful.
Posted By: Derid

Re: Healthcare - For Sinij - 11/20/12 06:38 PM


Thanks for admitting your loss, even if done in a snarky fashion.
Posted By: Sini

Re: Healthcare - For Sinij - 11/20/12 07:01 PM

I guess we got fairly good at getting each-other to roll our eyes.

In the future, please don't post something that reads like "you are too dumb to understand what I posted". While it is possible you could post something like that, chances that you too won't understand it.

I know enough economics to take you to task when you start misusing concepts to advance your arguments.
Posted By: Derid

Re: Healthcare - For Sinij - 11/20/12 07:14 PM


Then please dont cross post something to elicit a response, when only a day has passed and it took you two days to respond =p

Walls of text will be addressed when there is time to address wall of text.
Posted By: Sini

Re: Healthcare - For Sinij - 11/20/12 08:19 PM

Originally Posted By: Derid
Originally Posted By: sini
----

Point #1: Right or privilege, it still has to be done.


Point #2: Health care demand is inelastic; as a result costs are contained only by ‘net worth’ calculations.


Point #3: Wealth inequality creates a situation where increased profit taking from well-off consumers makes pricing bottom out of the market a profitable and acceptable business decision.


Point #4: Health care costs, at least in private sector research and development, are not driven by improving patient outcomes or quality of life but by maximizing profits.




Ok, so I chopped some of the quote to attempt to make it more readable. Much of what was chopped I think is inaccurate, but lets focus on the core issues:

Basically what you seem to be asserting in a nutshell, is that a combination of price controls and subsidies can solve all our health ills. (pun intended) Historically speaking, that type of economic management has led to a bread line - but lets go point by point.

Point#1 - most of your assertion that were valid regarding this were at the end, what you wrote for point#1 was mostly regarding your point#2. So lets move on to point #2

Point#2 - There are a few key things you bypass and ignore here. First of all, if a new treatment is not much better than the old treatment as you assert is a norm, then why is there a moral deficiency present when some people cannot afford the shiny new treatment?

Second, costs are actually in reality constrained by what Govt and Insurance (whose rates tend to follow Govt because Govt provides them with legal cover) is willing to pay - not what individuals are able to pay.

You also seem to ignore the fact that Supply and Demand is not an "aspect" of a "market economy". Supply and Demand is an absolute. A mistake many people make when doing an economic/social calculus and you appear to make - is confusing Demand for desire. Demand represents ability and willingness to pay as well as desire to pay. All your desire for price controls accomplishes is artificial limitation on demand. This creates economic distortions - more on this later.

Point#3 - This is an unfounded assertion, first and foremost. In fact, even current paradigm has large pharmaceuticals selling bulk, at reduced prices to even the undeveloped world after initial high-end USA market profit-taking. It would probably be fair to say that the rich will in many cases get *first access* to new products. This is true in some instances. Magic Johnson did not survive HIV in an era when it was a death sentence by being a poor nobody. But in most cases, long term strategy of not using developed IP and Mfg capacity simply because it is not as profitable per unit is not a viable business strategy. This is a recurring theme in your posts, but is more a worry than a real issue.

-----

Regarding your first paragraph of part 2, re: my objection to single payer. You absolutely did not address my concerns regarding price. When I talk about the pricing issue, you do not seem to understand what I am talking about - hence my snarky response to your cross-posting of this response in the other thread ( that, and the fact that you felt the snarky need to cross post to elicit a response, even though you took 2 days to respond.)

When I talk about pricing mechanisms, and pricing distortion I am referring to the question of - " How does a central entity properly determine and set price?". Because it cant. The market pricing process is a democratic process, where people literally vote on what a particular product or service is worth. Think of it as the original crowdsourcing. This process sends a signal to the world as to what something is worth, which lets potential suppliers determine if and whether supplying can be profitable and at what degree.

When this process gets disrupted by men with guns who arbitrarily set one unified price, then problems occur. Because the people setting the price, are almost never accurate in assessing the real value. A couple quick cases in point - the current drug shortages that worsen by the year, and the gas shortages in the Sandy aftermath. In the Sandy aftermath, "price gouging" was forbidden. So instead of gas and supplies being very expensive for a day, then prices dropping as new supply rolled in - there were extended shortages. Because the price people were "allowed" to charge did not reflect the extra costs, times and trouble that made shipping and distributing in extra supply worthwhile. So people either suffered without, or payed exorbitant prices from illegal black market.

--

Delivery of treatment is not a fixed cost. Many factors go into this pricing, including skill/schooling level required to provide, location, etc. Your groupings of cost types was also arbitrary and ineffective for the type of cost breakdown you attempted. You need much higher degree of granularity there to make it meaningful.

--

Point#4 - R&D is indeed a large cost. You are also correct in that some money goes to researching treatments as opposed to cures. However, the conclusion that follows from that.... has many untenable aspects.

First of all, there is generally no such thing as wasted health research. Often times breakthroughs come from unexpected places - people researching one thing, will find something that actually relates to a different problem.

Secondly, I demonstrated the correct model why single-payer countries could obtain bulk rates, because they were purchasing from a larger market. If they were trying to arbitrarily set a price, as opposed to buying at market rates then the efficiency would drop dramatically. They would either overpay and be less cost efficient, or underpay and face shortages of supply/quality.

Your assertion that single payer, were it to envelop the larger market - and attempt to set pricing by fiat - would not create shortages is a fallacy. This has been demonstrated by every other attempt at centralized price controls. The idea that a bureaucrat can determine proper value better than a market is pure fantasy. Already drug shortages are rampant in cases where the Federally mandated payout is not sufficient incentive for the drugs to be manufactured.

You argue that the Canada model where forced removal of patents to force companies to sell is a good model. Well, even as you admit your system would reduce R&D... in your world, exactly what new drugs or treatments would be available to be nationalized? If you know ahead of time that the Govt of the previously largest market is simply going to either rip you off, either by underpaying or nationalizing your efforts... what makes you think anything would be developed in the first place?

All the formerly market activity would now devolve into a political battle over what was "fair". There is no way an economy can operate in that environment.

---

You talk about rationally distributing health care. The only rational method, is to get Govt out of the health care business entirely. Health care is not something that springs from nothingness, to be distributed by fiat. It is something that many people must work very hard to provide and those services are not worthless. If we want to continue to have health care available to anyone but the wealthy who fly to non confiscatory countries for medical tourism, we need to immediately reverse course.

----



The Govt intervention in our system is the cause of our current mess. You talk like what we have now is a market system, but few things are further from the truth. Because we do NOT have a market system for health, and have not for some time- this is the cause of the present problems and spiraling costs.



I am not going to agree with your assertions on “market price”. What you describe is ideal-case scenario with unlimited access, perfect information and no outside influences. Buying and selling a sack of grain operates under these rules – there is plenty of grain, there are plenty of buyers, they are generally informed of the price and buyers are not forced to buy sack of grain 2.0 by outside entities regardless of its advantages over regular grain. Reality of health care “markets” is that it is a quagmire of patents, cross-licensing, multi-national regulations and exclusive provider contracts. You can argue that some or most of this is effects of government interference, but I have to point that you can’t possibly eliminate such interference and still have a system that produces safe products and protects investment into R&D.

To demonstrate the effects of above lets follow example of Oxycontin. First developed in 1916 by Bayer, and was still covered by various patents up until 2005! when latest version of the patent was thrown out by Court of Appeals. This is almost NINETY years of patent protection! How is it possible? Mostly it is patent games, generally you patent generic formula that produces low yield, then you patent ‘improvements’ or how you really went about manufacturing it to extend your patent coverage, then you dust off your safety data and publish all risks and patent reformulation that addresses or mitigates them. End result? Generics are kept out of the market for unreasonably long time, and in cases where one could manufacture generics regulation/policy are bought to mandate use of the newer product. Last but not least, you have education bias and kickback collusion schemes where doctors continue prescribing expensive drugs when generic alternatives exist. This example is pharmaceuticals, but it parallels in all other areas.

So why do we not just go with ‘old’ but cheaper versions? As I explained above, in too many circumstances we are prevented from doing so. Also in many instances insurance providers make this decision on your behalf, they cover latest-and-greatest, charge appropriately and ignore much-cheaper generic alternatives. Last but not least, there is demand for latest-and-greatest and since purchasing decision if largely removed from the consumer (insurance decides that for you) at no point is “let’s go with a cheaper generic” is seriously considered.

Point A: Consumer is largely removed from pricing decisions; as such the health care is biased toward latest-and-greatest, even when marginal improvements don’t warrant the additional costs.

Point B: Simplifying complex multi-party interactions to supply & demand leads you to wrong conclusions.

----

How does a central entity, as in single-payer, determine the price? It does it indirectly – it evaluates all possible treatments against its budget and determines the best use of that budget according to best possible outcomes. This results in a system that rationally assigns available dollars toward producing best possible outcome for the entire population, not an individual. If you price your treatment too high, it doesn’t get purchased. Occasionally, if treatment is deemed to be a question of national security (e.g. there is an epidemic, and you hold a patent for vaccine), there are no alternatives, and you are entirely unreasonable in your pricing, then government revokes its protection of your intellectual property in its jurisdiction. At no other point “men with guns” enter this negotiation, but there are plenty of accountants with spreadsheets that do.

As I demonstrated before, such system tends to contain costs and provide universal coverage. Again, single payer is not guaranteed to produce the best outcome for each individual, just the best overall outcome. I am also not opposed to two-tier system, but only as long as individual making purchasing decisions with their own money.

----

As to reduction of R&D under single-payer system. Government also sponsors a substantial portion of medical R&D, US have some of the most productive R&D programs covered with NIST grants. Even if all private research stopped, and it wouldn’t even with the worst case scenario, research and progress will still continue. Alternative that we are living in is having 50+ years old products withheld from the population and complete inability to control costs.
Posted By: Sini

Re: Healthcare - For Sinij - 11/20/12 08:21 PM

Originally Posted By: Derid

Walls of text will be addressed when there is time to address wall of text.


Cross posting if for my personal archival purposes.
Posted By: Sini

Re: Healthcare - For Sinij - 11/22/12 04:47 PM

“While what you say regarding consumers not being fully informed is true - it does not *need* to be true.”

Can you elaborate on this point? My understanding is if consumer is detached from the price of the treatment, and insurer operates on percentage margins, then by covering new and expensive treatments they are able to push overall costs up and by doing so increase their profit in absolute numbers without increasing efficiency of profit extraction. The only downward pressure is consumers having to pay higher insurance premiums, but with employer paying most of it, pressure is very minimal.

In traditional sense market would operate along the following decision-making lines – Treatment A(expensive) and Treatment B(affordable) are available. If I pay directly and I can’t afford treatment A, then I will go with treatment B. This puts market pressure on Treatment A to lower price to better compete with Treatment B. This is not how the system currently operates – Treatment A is picked every time, insurers pass the cost to employer who absorbs it into labor costs, and individual consumer has very little say in going with Treatment B. In turn, if employer wants to lower coverage costs, they go with an insurance plan that covers fewer conditions, has higher deductible or lower lifetime max; but if this cheaper plan covers a specific condition, they still go with a Treatment A.

This is why I think employer-sponsored insurance-pool health care is a dysfunctional system. Single payer system would be better. So is everyone paying out of pocket (and influencing prices via market forces) with only major conditions requiring insurance.

---

“Also, you have not "demonstrated" that such a system contains cost. You have made that assertion, but have made no inroads in modeling such a scenario where that occurs. Large scale systems where this style of intervention has been implemented have failed without exception.”

This is not a falsifiable argument, as such it is invalid. See: No True Scotsman fallacy.

If I bring up examples of any other First World country, you will claim (and have in the past) that scale is too small. If I bring up other US-based cases, such as VA or Active Military health care, you will claim it is too different.

Formally: ‘US health care’ is not ‘Other health care’ for all healthcare that is not ‘Other health care’ is not falsifiable as defined.

---

I am not denying that R&D will be affected. While I don’t think effects will be as drastic as you propose, I don’t want to focus our debate on this, and will concede that it will be reduced and leave it ‘reduced’ unspecified.

‘Silver lining’ of my plans is that under single payer employers will be largely free from providing health insurance, as such normalizing labor costs over part and full time. It will also lower overall employment costs, assuming that US is not an outlier and health care costs under single-payer drop to around 10%GDP observed in every other single-payer country. Additionally it will allow greater labor mobility, lessening ‘bennies lock-in’ and will afford more business creation, freeing individuals from concerns of finding individual health coverage.
Posted By: Derid

Re: Healthcare - For Sinij - 11/25/12 03:18 PM

Originally Posted By: sini
“While what you say regarding consumers not being fully informed is true - it does not *need* to be true.”

Can you elaborate on this point? My understanding is if consumer is detached from the price of the treatment, and insurer operates on percentage margins, then by covering new and expensive treatments they are able to push overall costs up and by doing so increase their profit in absolute numbers without increasing efficiency of profit extraction. The only downward pressure is consumers having to pay higher insurance premiums, but with employer paying most of it, pressure is very minimal.

In traditional sense market would operate along the following decision-making lines – Treatment A(expensive) and Treatment B(affordable) are available. If I pay directly and I can’t afford treatment A, then I will go with treatment B. This puts market pressure on Treatment A to lower price to better compete with Treatment B. This is not how the system currently operates – Treatment A is picked every time, insurers pass the cost to employer who absorbs it into labor costs, and individual consumer has very little say in going with Treatment B. In turn, if employer wants to lower coverage costs, they go with an insurance plan that covers fewer conditions, has higher deductible or lower lifetime max; but if this cheaper plan covers a specific condition, they still go with a Treatment A.

This is why I think employer-sponsored insurance-pool health care is a dysfunctional system. Single payer system would be better. So is everyone paying out of pocket (and influencing prices via market forces) with only major conditions requiring insurance.

---

“Also, you have not "demonstrated" that such a system contains cost. You have made that assertion, but have made no inroads in modeling such a scenario where that occurs. Large scale systems where this style of intervention has been implemented have failed without exception.”

This is not a falsifiable argument, as such it is invalid. See: No True Scotsman fallacy.

If I bring up examples of any other First World country, you will claim (and have in the past) that scale is too small. If I bring up other US-based cases, such as VA or Active Military health care, you will claim it is too different.

Formally: ‘US health care’ is not ‘Other health care’ for all healthcare that is not ‘Other health care’ is not falsifiable as defined.

---

I am not denying that R&D will be affected. While I don’t think effects will be as drastic as you propose, I don’t want to focus our debate on this, and will concede that it will be reduced and leave it ‘reduced’ unspecified.

‘Silver lining’ of my plans is that under single payer employers will be largely free from providing health insurance, as such normalizing labor costs over part and full time. It will also lower overall employment costs, assuming that US is not an outlier and health care costs under single-payer drop to around 10%GDP observed in every other single-payer country. Additionally it will allow greater labor mobility, lessening ‘bennies lock-in’ and will afford more business creation, freeing individuals from concerns of finding individual health coverage.


#1: Insurance

Your understanding is not particularly incorrect so much as it is incomplete. Most insurance plans have payment limits, which certainly influences choices and influences price.

I think your model of how insurance works is also slightly off, insurance companies do not want to pay more for the sake of paying more. In fact, their adjusters work extremely hard to work at paying less or nothing wherever feasible. Typically they charge as much in premiums as the market will bear, match benefits against their risk model and set limits and conditions accordingly, then work at minimizing their expenditure any way they can. Alternatively, consumers can negotiate with health providers based on the total pool of insurance available. Contrary to what some people seem to think - health care costs are in fact negotiable in most cases.

But lets step back for a second.

First to get a handle on this topic, we need to understand the purpose of insurance in a free market. The simplest way to put this, is to say that insurance exists to turn unpredictable costs into fixed costs. In a free society, the insurance providers with the best models that let them charge the least in premiums for the maximum possible protection will garner the most customers and generate the most profits.

If we understand this, we can quickly see how govt meddling with things can only cause chaos and add distortions to the calculations of the insurance providers which are forced to include govt in their calculations. One quick and simple example of a million possible: govt requiring plans to cover "substance abuse". The vast majority of people are at 0% risk of spontaneously contracting a bad case of "substance abuse" requiring treatment. However their premiums will now necessarily reflect not just the cost of turning their risk into fixed costs, but rather they are also paying what effectively amounts to taxes on their insurance - thus making good insurance less affordable. Even more importantly, it gets insurance away from its primary purpose for existing.

Now the first thing that comes to mind is "that clause is part of Obamacare, which requires everyone to pay into the insurance pool." Insurance companies are also limited in the amount of non-payout related expenses - only 20% can go to administration costs an profit taking. So yes, under the Obamacare paradigm insurance companies now ARE incentivized to pay more in terms of absolute payouts,because that is the only way they can increase absolute profit amounts. However this sorry and sad state of affairs is the result of incompetence in politics, not anything inherent to the concept of insurance itself.

Now, going back to information regarding the consumers. An educated consumer in a free market can and should be expected to analyze the cost/benefits of a particular insurance regime.The fact that some people *choose* not to take time to evaluate both insurance, and health options is not logically a concern of anyone else. It only becomes a concern when govt decides to force the rest of us to pick up the tab for people who neglect to do so. This is a mistake of govt, and should be abolished.

Non sequitur preemption: proper safety nets are not equivalent to subsidizing poor decisions.

There is no reason a person, often in conjunction with their primary care physician, should not be able and expected to make educated decisions regarding both insurance, and health options. Thats a large purpose of primary care physicians in fact: to help people make sensible health decisions. So its not like people have to make all these decisions without assistance.

If we step back, and look at the entire picture - from a birds eye perspective of society as a whole, it should be clear that using private insurance as a delivery means for social services is silly. All it does is leave insurance providers unable to properly perform their core function: sell amortization of the cost of risk.

But thats getting into another topic.

------------------------

#2 Discussion on the viability of the single payer:

You are wayyy off base here. Talk about ignoring context and antecedents.

The reason the single payer will not work here is because it runs afoul of the laws of economic calculation. My argument is not based on disproving your assertions to thusly prove my argument; I was simply explaining to you why they will not work. You tried to say an apple was an orange, I pointed out it was an apple. You tried to say a mouse was an elephant, I pointed out it was a mouse. But it is the laws of economic calculation that prevent your system from working, explaining where your assertions actually fit into the larger scheme of things does not a fallacy create.

Next.

----------------------------------------------------

You do not think it will be as drastic why? Its actually pretty easy to get a quick estimate on roughly the amount of the decrease using your model. You claim most delivery and etc costs are fixed, so the primary discretionary cost is in fact R&D which you claimed was a great portion of our overall health costs. So if our health expenditure is 18%GDP and falls to 10% GDP and our GDP is what approx 12T? Thats approx 960B less spent on health care. So where does this almost a T come from? One would have to assume the bulk would come from R&D.

Sure, the exact amount is hard to figure but a ballpark idea is pretty easy. Let say , conservatively, its at least 500B - and I think thats very conservative. Ultra conservative.

Anyhow, the thing that is hard to properly calculate is *how* it influences R&D exactly. Its not like most programs will continue - but with a small percentage of the funding. Figuring out which programs will be cut, which reduced, which kept - and the resultant loss of human progress and vitality is where it becomes impossible to determine.

You seem to think that somehow money would be magically invested in the "most efficient and valuable " products to rationally advance needed health care. In reality, I think we would simply see R&D primary focus on viagras, hair growth products, and other things that would cater exclusively to the affluent abbove and beyond govt mandated coverage. We could probably say bye bye to hard and to expensive research of niche conditions outside of curious university students.

The problem with the left, is that indeed - typically they do not want to focus on the utter devastation and chaos their policies cause. That is in fact *the* problem with the modern left. By putting on blinders and focusing laser-like on one specific issue at a time, while ignoring all the collateral damage, the modern left strangles and suffocates human development.

The left would have a lot more credibility if it cleaned up the side effects of its previously implemented policies before moving on to create new chaos and destruction.
Posted By: Sini

Re: Healthcare - For Sinij - 11/26/12 04:22 PM

#1

Quote:
I think your model of how insurance works is also slightly off, insurance companies do not want to pay more for the sake of paying more. In fact, their adjusters work extremely hard to work at paying less or nothing wherever feasible.


You are confusing two different issues here.

Ideally insurance wants to operate by providing coverage for any and all conditions, with minimum co-pays and deductibles and at the same time denying every single claim. This is rough model to maximize profit in ideal (to them) business environment.

We are not talking about denying claims here. We are talking about coverage. Coverage that insurance competes on. As such, I still stand by my assertion that chasing latest-and-greatest regardless of cost-effectiveness is forced on insurances by customer demands. This is mostly because customers are detached from individual purchasing decisions.

Quote:
Contrary to what some people seem to think - health care costs are in fact negotiable in most cases.


If you are paying directly, and in position to pay outright before the treatment, then yes, prices could be negotiated. Otherwise, not so much. Often times, the fact that you have insurance, even if they denied or only partially cover the treatment, locks you into inflated price due to how contracts for 'preferred provider' operate.

Anecdote - couple years back I had to get a treatment done. Insurance would only cover 50%. Doctor was not able to go down on the price as long as insurance paid any part of it. I negotiated direct payment deal that ended up saving me money over insurance coverage.

Quote:
There is no reason a person, often in conjunction with their primary care physician, should not be able and expected to make educated decisions regarding both insurance, and health options.


You can't claim this. Cost of individual coverage reserved to well-off and healthy. Majority of people are at the mercy of employer-provided health insurance plan. Your only choice is to opt in or opt out. As such, given that you are on the plan and have no choice about what this plan is, it is natural to consume up to the maximum within limitations of this plan and your personal health situation.


Quote:
If we step back, and look at the entire picture - from a birds eye perspective of society as a whole, it should be clear that using private insurance as a delivery means for social services is silly.


I agree. This why I see single-payer as an improvement over existing system. I also think that pure market driven system will happen to be improvement over status-quo (if you only consider monetary costs and ignore human costs).
Posted By: Derid

Re: Healthcare - For Sinij - 11/26/12 04:53 PM

Originally Posted By: sini
#1



You are confusing two different issues here.

Ideally insurance wants to operate by providing coverage for any and all conditions, with minimum co-pays and deductibles and at the same time denying every single claim. This is rough model to maximize profit in ideal (to them) business environment.

We are not talking about denying claims here. We are talking about coverage. Coverage that insurance competes on. As such, I still stand by my assertion that chasing latest-and-greatest regardless of cost-effectiveness is forced on insurances by customer demands. This is mostly because customers are detached from individual purchasing decisions.



No, though they also deny claims- insurance companies often negotiate pricing.

Quote:

If you are paying directly, and in position to pay outright before the treatment, then yes, prices could be negotiated. Otherwise, not so much. Often times, the fact that you have insurance, even if they denied or only partially cover the treatment, locks you into inflated price due to how contracts for 'preferred provider' operate.

Anecdote - couple years back I had to get a treatment done. Insurance would only cover 50%. Doctor was not able to go down on the price as long as insurance paid any part of it. I negotiated direct payment deal that ended up saving me money over insurance coverage.


Here is where it gets complicated. It depends on the nature of the ailment, the medical institution in question, what govt policy is regarding the ailment (ex: if there is a possiblity of govt picking up the tab if patient does not have insurance able to cover cost). In your case, while I have no idea what your ailment was (or need to know) , since you have indicated you are a high income individual - the health provider likely had a policy of not negotiating the price where insurance covered part because a lower income individual would have been able to have govt pick up the remainder of the cost.

Also, additionally it can also partially reflect the overall costs of doing business with govt. A dollar in hand better than 10 in the future and all.. knowing when and how much you will actually get paid carries a value as well. Especially when compared to govt payouts, which the medical facility probably institutionally expects during the majority of those cases - and hence writes policy around it.

I have a similar anecdote, where costs were entirely negotiated based on the amount of insurance payout available.

So, it just depends. In most cases its the govt that makes it complicated, though you can also find bureaucratic inefficiency and general human error on the part of providers as well.

Quote:


Quote:
There is no reason a person, often in conjunction with their primary care physician, should not be able and expected to make educated decisions regarding both insurance, and health options.


You can't claim this. Cost of individual coverage reserved to well-off and healthy. Majority of people are at the mercy of employer-provided health insurance plan. Your only choice is to opt in or opt out. As such, given that you are on the plan and have no choice about what this plan is, it is natural to consume up to the maximum within limitations of this plan and your personal health situation.


Sure I can claim this. Especially if we add in tax deduction for individual insurance purchases. Nixon just screwed the pooch with his HMO laws. People just got used to the idea of employer provided health insurance, because at the time employers thought it sounded like a good recruitment/retention tool because instead of paying $X more to employee to support insurance purchase, they could spend $X instead on insurance directly and recieve tax deduction.

It became so widespread, that some people have come to the mistaken conclusion that this is somehow the natural order of things - and how things should be. It isnt. Falling incidence of employer provided health is just a byproduct of falling real wages in general - and needs to be addressed with the wages issue, not with the health issue.

Just put individuals on the same tax terms as companies, and see people start demanding additional monetary compensation and pursuing their own health plans.


Quote:

Quote:
If we step back, and look at the entire picture - from a birds eye perspective of society as a whole, it should be clear that using private insurance as a delivery means for social services is silly.


I agree. This why I see single-payer as an improvement over existing system. I also think that pure market driven system will happen to be improvement over status-quo (if you only consider monetary costs and ignore human costs).


The human costs would be negative in terms of USA living standards - as in would be reduced in a free society. Simply opening up reimporting of patented items would serve as a huge boost to cost competitiveness as well. Companies wouldnt be able to overcharge us in the USA while low balling the cost to poorer parts of the world. Of course, prices would rise for people in poorer parts of the world - but my aim is not to subsidize the rest of the world, but rather to keep the USA sane.

In a single payer world with no market mechanism, it become impossible to calculate relative value. How much should a hip replacement cost? How much should a new drug cost? How much should phsyical therapy cost? Bureaucrats , no, any humans, are incapable of determining this.
Posted By: Sini

Re: Healthcare - For Sinij - 01/10/13 02:49 PM

Death Panels

Quote:
But the fact-checking only reduced belief in death panels among Palin supporters who otherwise had very little knowledge of politics—people who couldn’t say, for example, how many U.S. Senators there are in each state. By contrast, as shown in the picture, Palin supporters who also held basic knowledge of U.S. politics were resistant to fact-checking –debunking of the death panel myth not only failed to dissuade them from believing in death panels, but actually caused them to believe more strongly that such panels exist.
Posted By: Sini

Re: Healthcare - For Sinij - 01/11/13 03:26 PM

U.S. Lags Peers in Life Expectancy

Quote:
"The [U.S.] health disadvantage is pervasive—it affects all age groups up to age 75 and is observed for multiple diseases, biological and behavioral risk factors, and injuries," said the report's authors, who are public-health and medicine academics recruited by the government panels.


Most money spent, least results. Bad policy, ineffective spending = third world country results.
Posted By: Sethan

Re: Healthcare - For Sinij - 01/11/13 03:40 PM

But those 0.99 McDoubles are SOOOO good!
Posted By: Derid

Re: Healthcare - For Sinij - 01/11/13 04:58 PM

""The [U.S.] health disadvantage is pervasive—it affects all age groups up to age 75 and is observed for multiple diseases, biological and behavioral risk factors, and injuries," said the report's authors, who are public-health and medicine academics recruited by the government panels.

The shorter life expectancy for Americans largely was attributed to high mortality for men under age 50, from car crashes, accidents and violence. But the report also said U.S. women's gains in life expectancy had been lagging behind other well-off countries."

But the chairman of the panel of authors, Steven Woolf, a professor of family medicine at Virginia Commonwealth University, said the report showed that health outcomes were determined "by much more than health care."

"Our health as Americans is only partly aided by having a very good health-care system," he said. "Much of our health disadvantage comes from factors outside of the clinical system and outside of what doctors and hospitals can do."

The authors noted that Americans who lived past age 75 had higher survival rates compared with similar countries, and Americans overall had better rates of surviving cancer and strokes. They also said the U.S. better controls high blood pressure, cholesterol, smoking rates and use of alcohol than many other nations.""
--------------------------------------------------------

These are the important parts for this ongoing discussion. The rest is just political bias from the authors.
Posted By: Sini

Re: Healthcare - For Sinij - 01/11/13 05:15 PM

I noticed that too Derid, that why I included "policy" bit in my comments. I decided not to post this in that other thread, because nobody is reading anything there and just shouting at the screen.
Posted By: Daye

Re: Healthcare - For Sinij - 01/11/13 10:37 PM

Considering what the average quality of life looks like at 70 and beyond, I don't wish to live that long anyway.
Posted By: Sini

Re: Healthcare - For Sinij - 01/13/13 05:57 PM

Surprisingly, humanity is rather adaptive to circumstances. For example average long term happiness of a quadriplegic is about the same as a normal person. This unintuitive observations allows us to extrapolate to old age - chances are you will be happy and productive in your 70s, despite the fact that you'd be rather miserable if you were suddenly wake up tomorrow and find yourself 70.
Posted By: Sini

Re: Healthcare - For Sinij - 02/12/13 07:11 PM

Forbes: New Data Suggests Obamacare Is Actually Bending The Healthcare Cost Curve

Thanks to Obama, we are now living in post-truth, post-empirical evidence era of conservatism so none of this would register.
Posted By: Derid

Re: Healthcare - For Sinij - 02/12/13 08:51 PM

"To be sure, a big part of the decline in healthcare spending is the result of the recession’s impact on people’s ability to lay out cash on health related expenditures. "

Hmm. Might want to read the related articles regarding IRS rulings and predictions as well as examining the actual article again.

So, Obamacare "might" be contributing to some cost reductions - though of course the bulk of the implementation is yet to arrive. Seems a bit early to be talking up Obamacare and dismissing skepticism as somehow "post-truth".

You are free to have your own opinion, you are not however free to have your own facts.
Posted By: Wolfgang

Re: Healthcare - For Sinij - 02/12/13 09:30 PM

Originally Posted By: sini
Forbes: New Data Suggests Obamacare Is Actually Bending The Healthcare Cost Curve

Thanks to Obama, we are now living in post-truth, post-empirical evidence era of conservatism so none of this would register.


Oh well this is great news... so now tell me how come my fucking Insurance went up? Forbes is full of shit, along with anyone that believes that bullshit.

Let everyone buy Insurance across state lines, that alone would curb costs more than Obamacare ever would. Reality is a bitch, especially if you live in fantasy land aye Sini!
Posted By: Sini

Re: Healthcare - For Sinij - 02/12/13 09:35 PM

Originally Posted By: Derid
"Seems a bit early to be talking up Obamacare and dismissing skepticism as somehow "post-truth".


At the same time last year wasn't too early to blame Obamacare for raising premiums? How interesting.
Posted By: Sini

Re: Healthcare - For Sinij - 02/12/13 09:38 PM

Originally Posted By: Wolfgang
Oh well this is great news... so now tell me how come my fucking Insurance went up?


You smoke, you drink, you are overweight, high risk of cancer? You are one year older now?
Likely explanation is that your employer decided to cut costs and reduce contributions under the cover of Obamacare hysteria.
Posted By: Wolfgang

Re: Healthcare - For Sinij - 02/13/13 02:58 AM

Originally Posted By: sini
Originally Posted By: Wolfgang
Oh well this is great news... so now tell me how come my fucking Insurance went up?


You smoke, you drink, you are overweight, high risk of cancer? You are one year older now?
Likely explanation is that your employer decided to cut costs and reduce contributions under the cover of Obamacare hysteria.

Insurance cost increase was across the board for everyone. I'm not a smoker, nor am I a constant drinker. No reason for it to jump the way it did.
Just some more bullshit exscuses Get real, Obamacare is a joke even you liberal/progressives know this. But you're stuck on stupid for some reason. I don't know, maybe your mother didn't hug you enough.

Like I said and will continue to say, Open up Insurance across state lines and lets see some business competition between Insurance. You will see REAL cost drop or at the very least stay the same. Competition drives costs down, If you didn't know that, I almost feel sorry for you... ALMOST!
Posted By: Derid

Re: Healthcare - For Sinij - 02/13/13 06:16 AM


Healthcare premiums at my company jumped double digit percentages.... same with other companies I am aware of. My company gives public breakdown of costs, their costs rose quite a bit - they only passed on a minority of increased costs.

*Perhaps* it is possible that something in Obamacare is, for the nonce, helping insurance companies pay out less money. However it certainly has not been reflected in the premiums for anyone I have yet spoken with.
Posted By: Daye

Re: Healthcare - For Sinij - 02/13/13 10:42 PM

Same.

Contract negotiations are in progress but currently our healthcare
premiums are on track to triple this time around.
Posted By: Sini

Re: Healthcare - For Sinij - 05/05/13 12:44 AM

http://www.politifact.com/truth-o-meter/article/2013/may/03/new-study-medicaid-game-changer/
Posted By: Sini

Re: Healthcare - For Sinij - 05/14/13 10:54 PM

Healthcare Growth Contained

Quote:
Here's the story budget wonks will tell from today's Congressional Budget Office report: The deficit is poised to shrink to its lowest level since 2008.

Since August, CBO has now revised down its projections of mandatory health care spending by nearly $500 billion, as Michael Linden pointed out. Since the 2010 CBO report, projected Medicare spending between 2013 and 2020 has fallen by just over $1 trillion ... or 16%.
Posted By: Derid

Re: Healthcare - For Sinij - 05/15/13 12:50 AM


Lets see what its actually at once its spent. Some good news would be welcome from somewhere at this point though.
Posted By: Sini

Re: Healthcare - For Sinij - 05/25/13 03:58 AM

Forbes: Shocked by low California exchange rates
Posted By: Derid

Re: Healthcare - For Sinij - 06/01/13 08:11 PM

Ooooops

Looks like previous claims regarding CA were... not quite accurate.
Posted By: Kaotic

Re: Healthcare - For Sinij - 06/01/13 08:26 PM

Not to mention one of its primary tenets is falling apart.
Originally Posted By: GAO report
Finally, due to growing concerns about the rate of PCIP [Pre-existing Condition Insurance Program] spending, in February 2013, CCIIO [under HHS] suspended PCIP enrollment to ensure the appropriated funding would be sufficient to cover claims for current enrollees through the end of the program


Originally Posted By: President Obama
This year, tens of thousands of uninsured Americans with preexisting conditions, the parents of children who have a preexisting condition, will finally be able to purchase the coverage they need.
Guess not.
Posted By: Sini

Re: Healthcare - For Sinij - 06/01/13 10:31 PM

Originally Posted By: Derid
Ooooops

Looks like previous claims regarding CA were... not quite accurate.


I can tell you didn't read the article past the headline.

% they describe is for "25 year old male non-smoker, buying insurance for yourself" and it goes up by astronomical 50$ or so per month.

Dur Dur Dur.

Right wants to hate ACA so much that they don't care that it actually a good thing - both for increasing coverage and controlling the costs.
Posted By: Derid

Re: Healthcare - For Sinij - 06/01/13 11:22 PM

ACA is not a good thing for many reasons. You just dont seem to care much about the downsides.

Ive known plenty of 25 year olds where 50$ a month was a pretty big deal. Plus thats non-smoker... expect to start seeing people lie about their habits/health conditions just so they can make ends meet. This will throw the models and predictions all out of whack, and probably end up in exorbitant expenditures on litigation, enforcement and investigation in the future.

The only dur dur here is coming from you.
Posted By: Sini

Re: Healthcare - For Sinij - 06/02/13 03:38 PM

There is absolutely nothing I can say, no data I can present that would make you change your mind. ACA to hard right = Obama, and derangement syndrome kicks in.

Thing is, even with all that teeth gnashing majority of Americans are for it. So keep at it, and conservatism will end up discarded on the heap of history, right next to Whigs.

Democratic party as it exists today sufficiently conservative to fill "right" role, while left wing can separate and form a new party. This way GOP can fade into regional "Jesus and gun nuts" Southern party.
Posted By: Derid

Re: Healthcare - For Sinij - 06/02/13 10:43 PM


Last I saw majority of people was actually against it. But regardless that has nothing to do with whether its good or not.

Your right, not much you can say though - Obamacare is objectively bad. Left wingnut defense of it mostly revolves around blaming opposition to it on hatred of Obama. Which speaks volumes.
© 2019 The KGB Oracle