Poll

22 votes (66.66%)
11 votes (33.33%)

33 members have voted

EvenBob
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September 3rd, 2011 at 7:05:27 PM permalink
Quote: weaselman

That is already happening right now. That's how insurance works,



But everybody doesn't have insurance, do they.
"It's not called gambling if the math is on your side."
Nareed
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September 3rd, 2011 at 7:33:14 PM permalink
Quote: weaselman

I said that I wanted "free" health care in the same sense the police are "free".



the police are not free. keep that in mind.

Quote:

Same reason you don't want to pay for police and firefighters yourself.



I can't pay for police myself, because the use of force is properly a government monopoly. Imagine if we each had different police forces. We'd be fighting openly in no time.

I would pay for firefighters myself if that were an option. As it is, I contribute to both the Red Cross and firefighter fund-raising drives every year. It seems the government's too busy paying for the pensions of, among others, socialized medicine workers to pay enough for firefighters.

Quote:

Wrong again. Unless something catastrophic happens, it is actually going to be me paying for other people's healthcare with my taxes. But if it (something catastrophic) does happen, then yes, I want to be sure that my family isn't left to die on the street.



Then save your money, set up a trust fund and things like that, and quit trying to take other people's money.

And unless you have anything new to add, you'll be posting to yourself.
Donald Trump is a fucking criminal
AZDuffman
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September 3rd, 2011 at 7:42:12 PM permalink
Quote: weaselman

The percentages are meaningless. How did he come up with the number? The point is you should trust your doctor's opinion as a whole, not pick the parts you like. If he feels you should take the test, you should take it.

As for your question about the limits, that's an unanswerable question. I could just as well ask you for you limit for the doctor's certainty. If he was only 10% sure, would you take the test then? Would you spend $20,000? What is your limit?

This is precisely why we need insurance - to avoid asking ourselves these kinds of questions, that cannot really be answered.



I don't know what my limit would be, but I might very well shop around and get a second opinion. Your idea is why insurance gets so expensive--just take whatever they say and damn the cost. This is why we need to go to a system with say a $10,000 deductible and MSAs. That combines coverage with making patients good consumers.
All animals are equal, but some are more equal than others
weaselman
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September 3rd, 2011 at 8:13:31 PM permalink
Quote: EvenBob

But everybody doesn't have insurance, do they.


No, they don't. But out of those that do, 90% have nothing or almost nothing wrong with them, and have to "carry" the rest who are really really sick.
"When two people always agree one of them is unnecessary"
weaselman
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September 3rd, 2011 at 8:23:08 PM permalink
Quote: AZDuffman

I don't know what my limit would be, but I might very well shop around and get a second opinion.


Sure. But you'd be very unlikely to get a second opinion that you don't need the test. It's a liability thing. You come to the doctor, ask if you need the test, he says you don't, then you die, and your family sues his pants off.


Quote:

Your idea is why insurance gets so expensive--just take whatever they say and damn the cost.


That, yes. But shopping around does not help here - everybody is spoiled the same. A ten minutes doctor appointment costs several hundred dollars. That is why they won't give you a prescription over the phone :)

Quote:

This is why we need to go to a system with say a $10,000 deductible and MSAs. That combines coverage with making patients good consumers.


It does sound good, except ... If all policies have to be like that, pretty soon the premiums will raise to where they are now, so, you'll end up paying as much PLUS the deductible. And if not, then those with "normal" policy will be enough for the docs to keep the prices where they are.
What boggles my mind with the current situation is how come the doc's rates for the insurance are LOWER than if you pay out of pocket. I think, that should be illegal.
"When two people always agree one of them is unnecessary"
weaselman
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September 3rd, 2011 at 8:28:07 PM permalink
Quote: Nareed

the police are not free. keep that in mind.


I do keep that in mind. I want the same for healthcare.


Quote:


I can't pay for police myself, because the use of force is properly a government monopoly.


Not just force. There is also detective work, criminalistics, administration, transportation ...
The force would still be operated by the government, if you find that important for this discussion, you'd just have to pay for it.
Say, you are being threatened by some drunk mob. You can call police, but have to provide your account number with sufficient balance to pay for their services before they dispatch the help.

Quote:

I would pay for firefighters myself if that were an option. As it is, I contribute to both the Red Cross and firefighter fund-raising drives every year. It seems the government's too busy paying for the pensions of, among others, socialized medicine workers to pay enough for firefighters.


That's not what I am talking about.

Quote:

Then save your money, set up a trust fund and things like that


That's all great, except, if you start saving today, and get sick tomorrow ... oh well ...

Quote:

And unless you have anything new to add, you'll be posting to yourself.


Aren't we all in that position?
"When two people always agree one of them is unnecessary"
EvenBob
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September 3rd, 2011 at 8:33:35 PM permalink
Quote: weaselman

No, they don't. But out of those that do, 90% have nothing or almost nothing wrong with them, and have to "carry" the rest who are really really sick.



But the people who have no insurance now will never pay
for it, no matter what Obamacare says.
"It's not called gambling if the math is on your side."
weaselman
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September 3rd, 2011 at 8:47:23 PM permalink
Quote: EvenBob

But the people who have no insurance now will never pay
for it, no matter what Obamacare says.


Probably. But that's a different story, nothing to do with your 90/10 breakdown.
BTW, I am not defending Obamacare. I think, it is evil, just like the rest of us :)
"When two people always agree one of them is unnecessary"
SanchoPanza
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September 3rd, 2011 at 8:54:41 PM permalink
Quote: rxwine

The production of highly skilled, trained, certified, experienced physicians is limited.


Thanks to the A.M.A. and other powerful elements of the healthcare lobby. That problem has now come back to bite them on their bottoms.
MathExtremist
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September 3rd, 2011 at 10:10:12 PM permalink
Quote: weaselman

That is already happening right now. That's how insurance works, nothing to do with medicine, socialized or not.
The "good" thing about medicine is that most of those 90%, who do not currently have much wrong with them, sooner or later will, and then it will be their turn to become "free loaders". It does not completely even out of course (some people are just really sick for decades, and some are pretty healthy, and then just die), but a lot more so, then, say, auto insurance.


It's also the way fire and police services work: to reuse EvenBob's numbers (without necessarily agreeing with them) 80% of the population never needs the fire department, 10% have a kitten up a tree, and 10% have their house catch fire. The 90% with nothing or almost nothing wrong are going to pay for the 10% who do. That's how public goods work.

The issue isn't whether there is wealth redistribution going on in the current health-care system. Of course there is; as you noted, that's precisely what an insurance company does: it redistributes wealth from 100% of the premium payers to the small percentage who use covered services.

There are two fundamental policy questions here:
1) Is health care a public good, and
2) Should there be a for-profit company in the center of medical-premium wealth redistribution?

I think the answer to question 1 is a resounding yes. As to question 2, would you tolerate a middle-man who collected your property taxes, took a cut off the top, and then gave the rest to the government to hand out to the police and fire departments? If not, why is it tolerable when an insurance company does it with premiums?

I'll admit, I don't understand all the nuances of Obamacare. All I know is that the relevant provisions for me (guaranteed coverage; I work for myself) don't happen until 2014, by which time it will probably be repealed in some form. But it seems to me that a proper universal healthcare program would be run the same way as the existing universal national security program: your taxes go up, and that revenue funds a federal department to provide the benefits. In the case of healthcare, those benefits would be a minimum level of health coverage such as preventive, major medical, and well-baby. As with all taxes, the benefits received from the government are not equal for all citizens. Some people will be healthy and will subsidize others. But that's no different than, say FEMA -- I've never received a dime in FEMA benefits, nor do I expect to, but I'm fine with the government taxing me to pay for helping hurricane victims on the other side of the country. If I weren't, I might as well just give up on the "One Nation Under God" philosophy in favor of "A Whole Bunch Of Individuals Fending For Themselves Under God" instead.

Divided we fall. It's amazing how so many people don't get that.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
Nareed
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September 3rd, 2011 at 10:14:09 PM permalink
Quote: MathExtremist

As to question 2, would you tolerate a middle-man who collected your property taxes, took a cut off the top, and then gave the rest to the government to hand out to the police and fire departments? If not, why is it tolerable when an insurance company does it with premiums?



Why is it tolerable for the government to do it then?

BTW it's not like no one hires accountants to take care of their taxes.
Donald Trump is a fucking criminal
MathExtremist
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September 3rd, 2011 at 10:24:31 PM permalink
Quote: Nareed

Why is it tolerable for the government to do it then?


The government doesn't do it then. The government doesn't act as a for-profit middleman in taxation and revenue redistribution. There's overhead, sure, but they don't also take an extra 10% and say "we're just keeping this". An insurance company, on the other hand, does precisely that. It's that extra 10% (if the number is even close to that small) that represents a massively inefficient market. If it's a public good, it should not be exploited for profit by profit-driven companies.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
Nareed
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September 3rd, 2011 at 10:30:15 PM permalink
Quote: MathExtremist

The government doesn't do it then. The government doesn't act as a for-profit middleman in taxation and revenue redistribution. There's overhead, sure, but they don't also take an extra 10% and say "we're just keeping this".



Yes, they do. They take, for example, money earmarked for social security and replace it with government debt. Then they spend that money buying votes. Governments buy votes by giving handouts in the form of bailouts, welfare, school programs, etc etc etc.

Quote:

If it's a public good, it should not be exploited for profit by profit-driven companies.



It's not a public good. Healthcare is the result of massive efforts by a private industry.
Donald Trump is a fucking criminal
MathExtremist
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September 3rd, 2011 at 10:56:12 PM permalink
Quote: Nareed

It's not a public good. Healthcare is the result of massive efforts by a private industry.


If you disagree that maintaining the health of the citizenry is a public good then there's not much else to discuss. The U.S. already has socialized medicine, but only for veterans and those 65 and older. It's not obvious to me that half-way socialized medicine is better than either true universal healthcare or none at all, especially since the average cost for healthcare for those under 65 is so much lower than for those over.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
EvenBob
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September 3rd, 2011 at 10:59:53 PM permalink
Quote: MathExtremist



Divided we fall. It's amazing how so many people don't get that.



The gov't can't force us to buy something. Once we go down
that road there will be no end to it.
"It's not called gambling if the math is on your side."
thecesspit
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September 3rd, 2011 at 11:04:21 PM permalink
Quote: EvenBob

80% of the population have nothing wrong with
them. 10% have small problems. 10% have major
problems. The 90% with nothing or almost nothing
wrong are going to pay for the 10% who do. Thats
how socialized medicine works.



Is that how a completely private health insurance system would work? (I may have missed a key difference, if I assume that the 90/10 split is mostly unknown until the 10% get seriously ill).

(Ahh, you answered it elsewhere).
"Then you can admire the real gambler, who has neither eaten, slept, thought nor lived, he has so smarted under the scourge of his martingale, so suffered on the rack of his desire for a coup at trente-et-quarante" - Honore de Balzac, 1829
rxwine
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September 3rd, 2011 at 11:46:39 PM permalink
A private system needs to make a profit.

This is at odds with subsidizing low income people. You're are essentially selling them something they couldn't normally afford. On top of that, we have the battle cry to not force people into a common pool to bring down costs. So, it's a no win situation.

The other alternative is to make them go without.

edit, leastwise, I don't think you can make a profit without some sort of intervention to make it affordable for everyone.
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MathExtremist
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September 4th, 2011 at 12:06:47 AM permalink
Quote: EvenBob

The gov't can't force us to buy something. Once we go down
that road there will be no end to it.


They can, and do, all the time. They force you to buy an Army, interstate highways, medicine for the elderly, aid to foreign governments, missions to space, and the Internet, to name just a few. Why is public healthcare any different from that perspective?
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
EvenBob
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September 4th, 2011 at 12:25:06 AM permalink
Quote: MathExtremist

They can, and do, all the time. They force you to buy an Army, interstate highways, medicine for the elderly, aid to foreign governments, missions to space, and the Internet, to name just a few. Why is public healthcare any different from that perspective?



There's nothing they force you to buy with a penalty if you don't.
Quit being purposely obtuse.
"It's not called gambling if the math is on your side."
rxwine
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September 4th, 2011 at 12:36:40 AM permalink
Oh, there's definitely a monetary penalty added in by the IRS called "failure to pay" in addition to the tax you already owe if you decide you don't want to fund the government mission. Which include those things ME mentioned.
There's no secret. Just know what you're talking about before you open your mouth.
EvenBob
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September 4th, 2011 at 1:07:08 AM permalink
Quote: rxwine

Oh, there's definitely a monetary penalty added in by the IRS called "failure to pay"



The IRS forces you to buy nothing. You can spin this any way
you like, its currently illegal for the gov't to force you to buy
anything. Thats what the Supreme Court will decide on next
year.
"It's not called gambling if the math is on your side."
rxwine
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September 4th, 2011 at 1:25:10 AM permalink
Don't pay the IRS then, if that's what you really believe. Let me know how that works out for you.
There's no secret. Just know what you're talking about before you open your mouth.
EvenBob
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September 4th, 2011 at 1:45:39 AM permalink
Quote: rxwine

Don't pay the IRS then



They levy taxes on income, they don't penalize you
for not buying something. If you don't want to pay
taxes, don't earn anything. Obamacare forces you
to buy coverage if you want it or not. Thats illegal.
"It's not called gambling if the math is on your side."
Nareed
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September 4th, 2011 at 3:45:33 AM permalink
Quote: MathExtremist

They can, and do, all the time. They force you to buy an Army, interstate highways, medicine for the elderly, aid to foreign governments, missions to space, and the Internet, to name just a few. Why is public healthcare any different from that perspective?



Why is food different? Why are clothes different? Why are houses different? Why are cars different? Why not just let the government handle all production, then? Why not let the state be the sole owner of the entire economy? Why stop at all?
Donald Trump is a fucking criminal
rxwine
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September 4th, 2011 at 4:58:26 AM permalink
Quote: EvenBob

They levy taxes on income, they don't penalize you
for not buying something. If you don't want to pay
taxes, don't earn anything. Obamacare forces you
to buy coverage if you want it or not. Thats illegal.



C'mon, conservatives regularly say, I know how to spend my money better than the government in referring to taxes.

Spending money is buying something. Not paying the government incurs penalties.

Telling people that the solution to not buying is not earning money is stupid and not particularly viable, so it's a non-solution.
There's no secret. Just know what you're talking about before you open your mouth.
AZDuffman
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September 4th, 2011 at 5:00:59 AM permalink
Quote: weaselman

Sure. But you'd be very unlikely to get a second opinion that you don't need the test. It's a liability thing. You come to the doctor, ask if you need the test, he says you don't, then you die, and your family sues his pants off.



No, you go to the doctor and tell him what your symptoms are, then let him give an opinion unbiased by the first. Though you do have a point in that we need malpractice reform badly. Too many John Edwards types shaking down doctors like some member of the Bergin Hunt and Fish Club.

Quote:

That, yes. But shopping around does not help here - everybody is spoiled the same. A ten minutes doctor appointment costs several hundred dollars. That is why they won't give you a prescription over the phone :)



Several hundres? Seems a little high. BTW: if you have a doctor and a relationship with them they very often WILL call in your prescription. But a strange doctor will not because he is in business to make a profit. Same as when I was in pest control and some lady would not accept that I would not give her advice on "what to do herself" no matter how nice I tried to be about it. That happened a few times a year. People think a business is there to "help and be nice" not make money. A medical office is just as entitled to profit as any other business. Health care is NOT A RIGHT.


Quote:

It does sound good, except ... If all policies have to be like that, pretty soon the premiums will raise to where they are now, so, you'll end up paying as much PLUS the deductible. And if not, then those with "normal" policy will be enough for the docs to keep the prices where they are.
What boggles my mind with the current situation is how come the doc's rates for the insurance are LOWER than if you pay out of pocket. I think, that should be illegal.



No reason to believe any of this. My plan, should President Perry call me in 2013 to set it up would be a few simple steps:

1. Repeal ALL of Obamacare
2. Allow insurance to be sold across state lines, companies only have to offer what is mandated in the home state
3. Allow MSA's and encourage them with high-deductible policies
4. Those that want to pay $1K+ per month for $5 doctor visits may still do so, the more kinds of policies offered the better
5. All providers must post prices both in office and online for the top 80% of their procedures by volume

This way people could and would shop. This way doctors could offer bare-bones clinics or "Cadillac Buffet" limited practices and anything else in between. This way people have FREEDOM and not the destruction-of-the-Constitution that is Obamacare we will soon be living under.
All animals are equal, but some are more equal than others
rxwine
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September 4th, 2011 at 5:06:23 AM permalink
...anyway, I thought the specific objection was not that the government spends money on behalf of tax payers, but what it's allowed to do in that respect. Thus, trying to regulate it under the commerce clause.
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Nareed
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September 4th, 2011 at 5:15:27 AM permalink
Quote: rxwine

...anyway, I thought the specific objection was not that the government spends money on behalf of tax payers, but what it's allowed to do in that respect. Thus, trying to regulate it under the commerce clause.



The problem is the constitution does not give Congress the power to regulate any industries. Article I, Section 8, paragraph three reads: "To regulate Commerce with foreign Nations, and among the several States, and with the Indian Tribes;"

This means Congress can establish rules by which the trade between states, and foreign nations and Indian tribes, must be conducted. It does not mean regulate any and every aspect of any business or industry that affects interstate commerce.

Not that the actual text of the constitution seems to matter much any more.
Donald Trump is a fucking criminal
weaselman
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September 4th, 2011 at 7:18:47 AM permalink
Quote: EvenBob

Obamacare forces you
to buy coverage if you want it or not. Thats illegal.


I don't know if it is illegal, but it definitely is stupid.

They want a reform, but they are afraid to change anything. So instead of just adding insurance premiums to taxes for everyone, they are trying to leave people that already have insurance alone, and force those who do not buy it too. The only problem is, most people who don't have insurance don't have it not because they enjoy being uninsured, but because they have no means to buy it. Obamacare may be good for government (the new penalties will increase its profits), but it does nothing for us.
"When two people always agree one of them is unnecessary"
AZDuffman
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September 4th, 2011 at 7:26:08 AM permalink
Quote: weaselman

I don't know if it is illegal, but it definitely is stupid.



It is illegal. All you need to do is look at two simple points:

1. The U.S. Constitution is a "negative assumption" doccument. Meaning if the government was not specifically given the power to do something, it does not have that power.

2. The U.S. Constitution does not give the government power to force the peoples to buy a product or service.
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weaselman
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September 4th, 2011 at 7:47:36 AM permalink
Quote: AZDuffman

It is illegal. All you need to do is look at two simple points:


Indeed
:)
"When two people always agree one of them is unnecessary"
weaselman
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September 4th, 2011 at 7:54:53 AM permalink
Quote: AZDuffman


5. All providers must post prices both in office and online for the top 80% of their procedures by volume



I like number 5. But ... I am afraid, it's going to require a medical PhD (or whatever those are called) to read those postings :)
I had an appendectomy a few months ago, and was surprised to find out that the actual operation (the work of the surgeon, what, I am sure would be posted under the "Appendectomy" on the provider's site if they were required to post it) costs ... $180. Yup, less than an office visit :).
Of course, the insurance did end up paying in the neighborhood of $30K for that operation, starting with a 5 mile long ambulance ride (they had to transfer me to another branch, because they did not have an OR available) for $950 (I could rent a limousine for cheaper to get there), and ending with the "occupational therapy services" of a lady, who stopped by my room the day I was going home, and asked if I was being abused or something for $250.
"When two people always agree one of them is unnecessary"
MathExtremist
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September 4th, 2011 at 7:58:38 AM permalink
Quote: EvenBob

There's nothing they force you to buy with a penalty if you don't.
Quit being purposely obtuse.


I'm talking about funding universal healthcare with taxes. Your own advice is apropos.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
AZDuffman
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September 4th, 2011 at 8:09:44 AM permalink
Quote: weaselman

I like number 5. But ... I am afraid, it's going to require a medical PhD (or whatever those are called) to read those postings :)



That can be handled and I think smart providers would make it easy. Or simply suggest/require them to get with ISO and have simple terms for the same thing.

Most care is non-emergency. And there are medical practices who are sort of doing #5 already. Key is don't have the government decide how care can be priced. The most interesting practice I heard about was a doctor who limited his practice to a few hundred patients, charged a lot, and made office visits unlimited for one price. Patients got curb-service. He reduced his billing headaches 90%+. Everybody was happy.
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weaselman
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September 4th, 2011 at 8:17:00 AM permalink
Quote: AZDuffman

The most interesting practice I heard about was a doctor who limited his practice to a few hundred patients, charged a lot, and made office visits unlimited for one price. Patients got curb-service. He reduced his billing headaches 90%+. Everybody was happy.


That's only for the rich though. Would not work with insurance...
"When two people always agree one of them is unnecessary"
MathExtremist
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September 4th, 2011 at 8:30:56 AM permalink
Quote: Nareed

Why is food different? Why are clothes different? Why are houses different? Why are cars different? Why not just let the government handle all production, then? Why not let the state be the sole owner of the entire economy? Why stop at all?


Two reasons:
1) You're not making a distinction between basic needs and other goods/services, and
2) You're missing the distinction between production and providing a minimum level of access.

For example, the government does not produce food. But food is a basic need, so the government does subsidize farmers, and it also provides a minimum level of access to food via food-stamp and other welfare programs. Neither does the government produce cars, but cars are not recognized as a basic societal necessity, so there you're on your own. For those basic needs which society has agreed upon, the government provides minimum levels of access to those needs, and you're free to buy up if you have the money. For example:


Basic need Government-supported level Options for wealthier individuals
Food Food stamps Restaurants
Clothing / Housing Welfare / Homeless Shelters Neiman-Marcus / Anthem Country Club
Education Public schools Private schools, tutors
Security Police Private security forces
Healthcare Nothing unless you're older than 65. Medical insurance, boutique doctors


The problem is that there is no agreement that healthcare is a basic need, like food or education. Providing basic coverage with taxes leads to greater GDP than letting a percentage of the population go under-insured to rely on costly emergency services, and the tax costs are lower. U.S. corporations offer healthcare because they can -- group policies are available at a write-off -- but also because they know healthy employees produce more goods and services. But the lack of healthcare policy at the public level encourages workers to stay at larger companies with medical insurance, and discourages entrepreneurial thinkers at those companies from quitting to start small businesses (which are one of the largest contributors to jobs and economic growth).

I'd bet that putting a healthcare safety net underneath individuals would immediately spawn at least 100,000 new businesses, all of which would be run by the sort of people savvy enough to think about risk properly. That's just the sort of shot in the arm this economy needs. But we won't get it as long as (a) the insurance lobby successfully plies its trade and (b) naive citizens think that taxation is evil. It is this rabid anti-tax theme that is so dangerous to our society. Like I said before, divided we fall. Right now we're divided, and the economy is falling. Go figure.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
Nareed
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September 4th, 2011 at 8:43:30 AM permalink
Wow! So medicaid, medicare, SCHIP and Bush's senior citizen prescription drug entitlement are nothing?

Remarkable.
Donald Trump is a fucking criminal
Nareed
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September 4th, 2011 at 8:46:54 AM permalink
Quote: MathExtremist

I'd bet that putting a healthcare safety net underneath individuals would immediately spawn at least 100,000 new businesses, all of which would be run by the sort of people savvy enough to think about risk properly. That's just the sort of shot in the arm this economy needs.



More make work jobs that produce nothing won't help the economy. You might as well mandate a guard for every utility pole in the country, and specify such duty will be undertaken by private security firms contracted by local governments. That would "create" millions of "jobs" and "stimulate" the economy, right? Make them armed guards and you'll "stimulate" arms manufacturers as well.
Donald Trump is a fucking criminal
AZDuffman
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September 4th, 2011 at 9:26:21 AM permalink
Quote: weaselman

That's only for the rich though. Would not work with insurance...



So what? Lots of people might prefer paying upfront over an insurance middleman. Know your office visit costs and have a high-deductible premium for the emergencies. And the "buffet" cost helps meet the deductible.

There was another example I saw of a clinic where no insurance was even taken, prices were posted on a wall and you paid at time of service. Very simple. The money saved by not taking insurance was plowed into keeping prices lower.
All animals are equal, but some are more equal than others
boymimbo
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September 4th, 2011 at 9:40:21 AM permalink
Quote: Nareed

My father spend a month in intensive care before he passed away. The bill came to hundreds of thousands of dollars, and his insurance, which he'd been paying out of his pocket for decades, covered all of it.



Why did it cost hundreds of thousands of dollars? What is the true cost of providing that care? How much profit did the hospital take? How much profit did the pharmaceutical company take? How much profit did the doctor take? How much profit did the insurance company take? How much administrative overhead was taken for the doctor to bill the hospital to bill the insurance company?

If my dad goes to ICU, he pays nothing. The hospital gets overall funding from my province to fund the ICU. Doctors bill OHIP at a prescribed rate for that service based on a table. All of the support staff get paid on a prescribed hourly fee. Pharmaceutical drugs are bought at a provincially or nationally negotiated rate. Yep, there is an infrastructure in place of government workers getting union wages that determine things like rate, make sure that doctor's payments are made, and so on and so forth. But we Canadians believe that everyone should be covered regardless of income and we don't generally have a problem using our taxes to fund healthcare. We also KNOW that this system and the way that it is organized results in much cheaper costs and the same quality of care (when it comes to ICU) that the US gets. That's why most Canadians are not screaming for a private system, nor is any other country with socialized medicine. We are educated as to how the US system works, and realize that to 90% of Canadians, it's unaffordable, and unfair. We also realize that for a given cost, we can jump the waiting list and cross the border to get a number of procedures, checkups, and so on and so forth just by paying for it, and several high-profile Canadians have done just that. Similarly, poor Amercians can jump the border as well into Canada and get care for much much cheaper. And that happens all of the time. And I know this from working at a Vancouver area hospital for 8 years. Americans come to our emergency rooms, pay $250 to get treated and then leave. Our system is not perfect.

The US system is so inequitable because once you're out of work, you have no insurance that's affordable. So you don't pay insurance and run the risk of becoming bankrupt. And how is that fair? And it's no longer fair to US companies either to provide health care insurance costs to its employees either as it's too expensive.
----- You want the truth! You can't handle the truth!
MathExtremist
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September 4th, 2011 at 9:40:33 AM permalink
Quote: Nareed

Wow! So medicaid, medicare, SCHIP and Bush's senior citizen prescription drug entitlement are nothing?

Remarkable.


Amended.

Curious how conservatives rail against socialized medicine but won't think about voting down medicaid and medicare.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
ItsCalledSoccer
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September 4th, 2011 at 9:43:55 AM permalink
Quote: AZDuffman

So what? Lots of people might prefer paying upfront over an insurance middleman. Know your office visit costs and have a high-deductible premium for the emergencies. And the "buffet" cost helps meet the deductible.

There was another example I saw of a clinic where no insurance was even taken, prices were posted on a wall and you paid at time of service. Very simple. The money saved by not taking insurance was plowed into keeping prices lower.



You may be pounding sand here. Weaselman's starting assumption is that the same thing works for and is preferred by everybody, and he's ready to tell, if not force everyone to do the same thing ... or at least severely limit the choices. Never-minding intrusions on liberty that Obamacare has, the thinking that government can do what the free market can do borders on insane.

Obamacare isn't the answer. Freeing up the market is. You don't double-down on 22 because you've already lost. Similarly, you don't double-down on constrains when those are the problem. You're literally betting money on a result you already know to be a loss. Insane.
MathExtremist
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September 4th, 2011 at 9:50:24 AM permalink
Quote: Nareed

More make work jobs that produce nothing won't help the economy. You might as well mandate a guard for every utility pole in the country, and specify such duty will be undertaken by private security firms contracted by local governments. That would "create" millions of "jobs" and "stimulate" the economy, right? Make them armed guards and you'll "stimulate" arms manufacturers as well.


Comprehend, please. The sort of companies started by intelligent entrepreneurs are not "make work jobs that produce nothing". They are the small businesses that formed the backbone of this society and that turned into the megacorporations of today. Israel has a thriving 35-and-up entrepreneurial class because they have a safety net underneath the founders -- if the company fails, the CEO's kids don't go without medical care. We don't have that in the U.S., and as a result the majority of high-value entrepreneurial growth is led by younger, less experienced executives with nothing to lose. When I was in my 20s, I did all sorts of startups. My bosses were all 26-27 and single. You don't see as many 45-year-olds willing to leave the cushy corporate world to start a new venture because they have spouses and teenage kids who need healthcare that they wouldn't have by "jumping off the cliff". The U.S. government could very easily boost job growth and the economy with a universal healthcare safety net so insurance isn't tied to working at a big corporation. That would allow many people now to quit their jobs and start new companies. Right now, if you're sick, you're stuck working at someone else's company. You cannot afford the risk to start your own, even if you can afford the startup costs.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
AZDuffman
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September 4th, 2011 at 9:58:53 AM permalink
Quote: boymimbo

How much profit did the hospital take? How much profit did the pharmaceutical company take? How much profit did the doctor take? How much profit did the insurance company take? How much administrative overhead was taken for the doctor to bill the hospital to bill the insurance company?



What difference does it make if they make "profit?" You don't complain because the grocery store, restaurant, or the like makes "profit." But somehow "profit" is not supposed to be allowed in health care. Why not? After all, we are not communists.
All animals are equal, but some are more equal than others
weaselman
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September 4th, 2011 at 10:26:34 AM permalink
Quote: ItsCalledSoccer

You may be pounding sand here. Weaselman's starting assumption is that the same thing works for and is preferred by everybody, and he's ready to tell, if not force everyone to do the same thing ... or at least severely limit the choices.



I did not realize that was my starting assumption :)

That's not what I was trying to say at all. No, I don't want to force everybody do the same thing. I am a libertarian (don't laugh, I am :) At least, everywhere, where it does not involve the government letting its people die and suffer under the disguise of "choice"), and I think that everybody should be able to do whatever they want. I never said that private insurance should be outlawed. I just want another alternative. I am in fact for MORE choice, not less.


Quote:

Never-minding intrusions on liberty that Obamacare has, the thinking that government can do what the free market can do borders on insane.



I am not thinking that. To the contrary. I think, that the government can do what the market can not.


Quote:

Obamacare isn't the answer.


Agreed, 100%.

Quote:

Freeing up the market is.


What is it that's not free right now? Are you suggesting that insurance companies go completely unregulated? And that will magically drive the prices down? How?
"When two people always agree one of them is unnecessary"
Nareed
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September 4th, 2011 at 10:32:20 AM permalink
Quote: MathExtremist

Amended.



Medicaid has no age threshold, SCHIP applies to children. Yet you say "Nothing unless you're over 65."

What's the use of lying? Other than trying to hide that government meddling in the market place is what's screwed up healthcare.

Quote:

Curious how conservatives rail against socialized medicine but won't think about voting down medicaid and medicare.



I'm not a conservative. I think all government welfare and all "entitlements" should be abolished.
Donald Trump is a fucking criminal
MathExtremist
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September 4th, 2011 at 11:10:05 AM permalink
Quote: Nareed

Liar.

I'm not a conservative. I think all government welfare and all "entitlements" should be abolished.


I can admit my mistakes. Calling me a liar for making them is unwarranted and rude. But rather than address the premise of my arguments, you've chosen to find fault with the specifics of my wording. Since I'm unable to convince you to have a conversation on the premise I set forth, let's focus on yours. You suggest abolishing all government welfare and entitlements. Which of the following do you keep?

Social Security
Food stamps
Medicare
US Dept. of Agriculture farm subsidies
Medicaid
US Dept. of Veterans Affairs
Bureau of Indian Affairs
US Agency for International Development (foreign aid)
US Dept. of Agriculture Food and Nutrition Services
Federal Emergency Management Agency

If your answer is "none of the above", then I respectfully submit that your philosophy runs counter to the premise of the Founding Fathers when they wrote the Preamble to the US Constitution. If everyone was intended to fend for themselves, there was no purpose whatsoever in forming a Union. Divided we fall.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
ItsCalledSoccer
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September 4th, 2011 at 11:13:33 AM permalink
Quote: weaselman

I did realize that was my starting assumption :)



Like I

Quote: weaselman

That's what I was trying to say at all. I want to force everybody do the same thing.



said, it's

Quote: weaselman

At least, everywhere, where it does not involve the government letting its people die and suffer under the disguise of "choice"),



pounding sand.

Quote: weaselman

I just want another alternative. I am in fact for MORE choice, not less. I am not thinking that.



Leave your hyper-parsing and

Quote: weaselman

To the contrary. I think, that the government can do what the market can not.



intentional omissions for Nareed.

Quote: weaselman

Agreed, 100%.



Thanks for agreeing.

Quote: weaselman

What is it that's not free right now?



This board is free. Which may be why you spend so much time trying to "win" it. It's MKL all over again.

Quote: weaselman

And that will magically drive the prices down?



It's free already. WTF are you even talking about?

[/sarcasm]

I can see taking on an argument point-by-point. But super-hyper-overparsing while picking-and-choosing what to keep and what to disregard lends no continuity and, frankly, exposes that there are parts that you cannot explain and therefore ignore. Which is, of course, free. But the government really should step in with you because it's clear you can't formulate a response. It can do what you cannot.

OK, so NOW it's [/sarcasm]
Nareed
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September 4th, 2011 at 11:16:59 AM permalink
Quote: MathExtremist

If your answer is "none of the above", then I respectfully submit that your philosophy runs counter to the premise of the Founding Fathers when they wrote the Preamble to the US Constitution. If everyone was intended to fend for themselves, there was no purpose whatsoever in forming a Union. Divided we fall.



the preamble of the Constitution, and by that I take it you mean the frequently misunderstood "Welfare Clause," does not mandate or require any kind of welfare.The Founders wrote the Constitution to delineate the powers of government. The infamous "Welfare Clause," is not a clause like that of a contract or a legal document, but just one clause in a sentence. You never hear about the "To secure the blessings of liberty clause," do you?

In any case, if "General Welfare" were the whole of the importance of the Constitution, why then delineate any government powers at all? Why not just write that government can do anything it deems necessary to "promote the general welfare"?

Because the Founders did not intend government to take on the role it has taken. if they had, they would have provided for it. Instead politicians and jurists throughout the past 2+ centuries have either ignored or misinterpreted the Constitution for their own purposes.

And to answer your question, I'd keep none of them.
Donald Trump is a fucking criminal
MathExtremist
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September 4th, 2011 at 11:18:31 AM permalink
Quote: AZDuffman

What difference does it make if they make "profit?" You don't complain because the grocery store, restaurant, or the like makes "profit." But somehow "profit" is not supposed to be allowed in health care. Why not? After all, we are not communists.


Nobody is arguing that profit is not allowed in health care. The problem with health care is that there is no effective alternative. If you cannot access a restaurant, you can still access food stamps. If you cannot access private education, you can still access public education. If you cannot access private healthcare, and you do not fall into one of the existing socialized medical insurance programs, you have no access whatsoever. In 2008 there were over 25 million Americans who either had no health coverage or had insufficient health coverage. Corporate profiteering should not be allowed to stand in the way of a healthy and productive American workforce. To suggest otherwise is to elevate the desires of a small number of corporate shareholders above the needs of the public as a whole. Such is not the purpose of government in a civilized society.
"In my own case, when it seemed to me after a long illness that death was close at hand, I found no little solace in playing constantly at dice." -- Girolamo Cardano, 1563
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