Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 09-23-2010, 02:07 PM   #41
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by NW Landlady View Post
One of the major differences between the US & other countries is the Tort Liability System. Much of the cost of Healthcare is the cost of Malpractice & liability insurance built into it. We are talking really large sums of money here. Many doctors & facilities cannot afford it or build it into the cost of medical services. The new HC Bill does very little to reduce the cost of medical services, (there is a small sure-to-fail-pittance given to the states for Tort Reform which is doomed IMO given the funds/strength of the BAR & such). Drugs & medical devices are expensive in the US for the same reason. The US is flooded with ambulance chasing attorneys encourage potential litigants to sue for "bad" drugs, etc.
Before you blow a gasket at the evils of the BAR, step back and look at the data. Here is a study which shows that about 2.4% of our healthcare costs is due to malpractice related items: National Costs Of The Medical Liability System -- Mello et al. 29 (9): 1569 -- Health Affairs. Most is defensive medicine and that may not disappear if malpractice is dealt with differently.

There are states, like Wisconsin, where malpractice insurance costs are low in part due to caps and due to a compensation fund. Health care still costs a lot in Wisconsin.

(I find it interesting that we want to cap malpractice for doctors and we have short statutes of limitations for the claims. But legal malpractice claims get no caps and long statutes of limitation for malpractice. I guess we like the medical profession and not the legal? )
__________________

__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 09-23-2010, 02:44 PM   #42
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
RonBoyd's Avatar
 
Join Date: Dec 2007
Location: Denver, Colorado
Posts: 5,280
Quote:
Originally Posted by Emeritus View Post
I'm not sure if Americans are not just mentally defective or simply so stupid and greedy that they cannot figure it out
Are you thinking of the Metric System proposal?
__________________

__________________
"It's tough to make predictions, especially when it involves the future." ~Attributed to many
"In theory, there is no difference between theory and practice. But, in practice, there is." ~(perhaps by) Yogi Berra
"Those who have knowledge, don't predict. Those who predict, don't have knowledge."~ Lau tzu
RonBoyd is offline   Reply With Quote
Old 09-23-2010, 02:52 PM   #43
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,411
Quote:
Originally Posted by ERD50 View Post
Yes, I was surprised how little attention the Swiss system got in this whole debate leading up to what we got. I could be 'sold' on the Swiss system, and I'm a tough 'sell'.

Makes me wonder - how did the Swiss manage to do it?

-ERD50
They don't get sick as often. When they do, more of the care is provided by the family doctor.
__________________
MichaelB is online now   Reply With Quote
Old 09-23-2010, 02:55 PM   #44
Moderator
ziggy29's Avatar
 
Join Date: Oct 2005
Location: Texas
Posts: 15,612
Quote:
Originally Posted by M Paquette View Post
Tort reform would be a good thing, but it's not going to have a significant impact on the costs of health care on it's own.
I think there are a lot of things which make relatively minor differences on their own, but collectively make a big difference. The problem is that half of these things are opposed by one side of the public policy debate, and the other half of these things are opposed by the other side.

And since the tendency is for neither side to give the other what they want (that would be defeat -- or worse, compromise) -- we get little of the things that will really matter in terms of cost control.
__________________
"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

RIP to Reemy, my avatar dog (2003 - 9/16/2017)
ziggy29 is offline   Reply With Quote
Old 09-23-2010, 02:59 PM   #45
Thinks s/he gets paid by the post
teejayevans's Avatar
 
Join Date: Sep 2006
Posts: 1,219
Quote:
Originally Posted by FinanceDude View Post
If unemployment was not almost 10%, that number would drop...........not many folks in America who are unemployed can afford insurance........
The meat of this bill doesn't take affect until 2014, in the what have you done for me lately, this bill is a total bust.
TJ
__________________
teejayevans is offline   Reply With Quote
Old 09-23-2010, 03:02 PM   #46
Recycles dryer sheets
NW Landlady's Avatar
 
Join Date: Jun 2010
Location: Seatlle
Posts: 185
Quote:
Originally Posted by Martha View Post
Before you blow a gasket at the evils of the BAR, step back and look at the data. Here is a study which shows that about 2.4% of our healthcare costs is due to malpractice related items: National Costs Of The Medical Liability System -- Mello et al. 29 (9): 1569 -- Health Affairs. Most is defensive medicine and that may not disappear if malpractice is dealt with differently.

There are states, like Wisconsin, where malpractice insurance costs are low in part due to caps and due to a compensation fund. Health care still costs a lot in Wisconsin.

(I find it interesting that we want to cap malpractice for doctors and we have short statutes of limitations for the claims. But legal malpractice claims get no caps and long statutes of limitation for malpractice. I guess we like the medical profession and not the legal? )
Your link does not say more than a paragraph & a statement, not criticizing, just curious as to what the other 97.6% of the costs are attributed to. Does anyone know?

Here is a comparison online (take it with usual grain of salt) by country. Note the $ per capita difference between US & other countries with better healthcare: Healthcare Costs Around the World |
__________________
NW Landlady is offline   Reply With Quote
Old 09-23-2010, 03:12 PM   #47
Moderator Emeritus
Rich_by_the_Bay's Avatar
 
Join Date: Feb 2006
Location: San Francisco
Posts: 8,827
Quote:
Originally Posted by NW Landlady View Post
just curious as to what the other 97.6% of the costs are attributed to. Does anyone know?
Unnecessary or unproven high tech imaging and testing, aggressive end-of-life care for elderly or chroniically ill patients with no meaningful hope for recovery in any event; tens of millions of uninsured or underinsured who uses the hospital ER for primary care, pandemic obesity; untreated hypertension, diabetes and other diseases with effective treatment available; pharmaceutical abuses and numerous "me-too" drugs of no added value to old stand-by drugs; a 25-30% administrative cost on every dollar of services; neglected prenatal care; rampant violence in certain locations requiring massive trauma care; lack of primary care physicians who can deflect a reflex referral to subspecialists (who often a buck-stops-here approach which is costly and is sometimes avoidable with no adverse consequences.

I'm just getting warmed up, but I'll give it a rest.
__________________
Rich
San Francisco Area
ESR'd March 2010. FIRE'd January 2011.

As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
Rich_by_the_Bay is offline   Reply With Quote
Old 09-23-2010, 03:15 PM   #48
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas Hill Country
Posts: 42,072
I think someone struck a nerve... but that's only a non-medical opinion.
__________________
Numbers is hard

When I hit 70, it hit back

Retired in 2005 at age 58, no pension
REWahoo is offline   Reply With Quote
Old 09-23-2010, 03:31 PM   #49
Moderator Emeritus
 
Join Date: Oct 2007
Posts: 4,929
Quote:
Originally Posted by teejayevans View Post
The meat of this bill doesn't take affect until 2014, in the what have you done for me lately, this bill is a total bust.
TJ
The Swiss system didn't go fully into effect until five years after the bill was passed. They had to go through a similar series of transitions. Some of the changes were significantly larger, such as the basic care insurance being forced to become organized as a non-profit. (Optional care packages and various add-ons continue to operate as for-profit insurance sales.)

When Switzerland relied on U.S.-style for-profit health insurance, many people were denied coverage altogether. Many others had to fight constant battles with insurers to get their bills paid. In the new Swiss system, essentially everybody has insurance, and the companies are not allowed to deny a claim. (In fact, they generally pay all claims within five days.) The Swiss people are happier with this system than with what they had before.

The trick in the US will be to somehow force failure early in the transition process, before benefits of any changes are seen by most folks, so as to convince the populace that 'change is bad.' Toward that end, we have actions such as several large insurers are taking today. If we allow the US transition to proceed to the point where people see the benefits, and the fringe fears (death panels, soylent green, etc) fail to be realized, then it will be much more difficult to undo the changes.
__________________
M Paquette is offline   Reply With Quote
Old 09-23-2010, 04:55 PM   #50
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
travelover's Avatar
 
Join Date: Mar 2007
Posts: 9,871
Quote:
Originally Posted by Rich_in_Tampa View Post
....... aggressive end-of-life care for elderly or chronically ill patients with no meaningful hope for recovery in any event; .............
See? I told ya they were gonna kill my grandmother!
__________________
Yes, I have achieved work / life balance.
travelover is offline   Reply With Quote
Old 09-23-2010, 05:53 PM   #51
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
dex's Avatar
 
Join Date: Oct 2003
Posts: 5,105
Quote:
Originally Posted by travelover View Post
See? I told ya they were gonna kill my grandmother!
How it will end?



&

__________________
Sometimes death is not as tragic as not knowing how to live. This man knew how to live--and how to make others glad they were living. - Jack Benny at Nat King Cole's funeral
dex is offline   Reply With Quote
Old 09-23-2010, 06:47 PM   #52
Full time employment: Posting here.
 
Join Date: Feb 2009
Posts: 886
Quote:
Originally Posted by Martha View Post
Or care is forgone.

Nearly 45,000 annual deaths are associated with lack of health insurance, according to a 2009 study published by the American Journal of Public Health. That figure is us considerably from the 18,000 shown in a 2002 study, which I reported on before.

The study found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.
New study finds 45,000 deaths annually linked to lack of health coverage | HarvardScience
Actually its a little more complicated. you have to include the people who die because they have health insurance who would not have died if they had stayed away from doctors.
Iatrogenic Disease: The 3rd Most Fatal Disease in the USA
__________________
Emeritus is offline   Reply With Quote
Old 09-23-2010, 06:56 PM   #53
Thinks s/he gets paid by the post
DblDoc's Avatar
 
Join Date: Aug 2007
Posts: 1,224
Quote:
Originally Posted by Rich_in_Tampa View Post
Unnecessary or unproven high tech imaging and testing, aggressive end-of-life care for elderly or chroniically ill patients with no meaningful hope for recovery in any event; tens of millions of uninsured or underinsured who uses the hospital ER for primary care, pandemic obesity; untreated hypertension, diabetes and other diseases with effective treatment available; pharmaceutical abuses and numerous "me-too" drugs of no added value to old stand-by drugs; a 25-30% administrative cost on every dollar of services; neglected prenatal care; rampant violence in certain locations requiring massive trauma care; lack of primary care physicians who can deflect a reflex referral to subspecialists (who often a buck-stops-here approach which is costly and is sometimes avoidable with no adverse consequences.

I'm just getting warmed up, but I'll give it a rest.
I'll pick up the baton...

Advertising dollars promoting medications/treatments/my clinic is better than your clinic. Defensive medicine (the hidden cost of malpractice). Skewed compensation for procedures over prevention. The sense of entitlement of patients - I want this and I want it now!

DD
__________________
At 54% of FIRE target
DblDoc is offline   Reply With Quote
Old 09-24-2010, 01:11 AM   #54
Thinks s/he gets paid by the post
obgyn65's Avatar
 
Join Date: Sep 2010
Location: midwestern city
Posts: 4,061
For those who are interested, here is the full timeline of changes thanks to the Affordable Care Act:

What?s Changing and When - Timeline: What's Changing and When | Understand the New Law | HealthCare.gov
__________________
Very conservative with investments. Not ER'd yet, 48 years old. Please do not take anything I write or imply as legal, financial or medical advice directed to you. Contact your own financial advisor, healthcare provider, or attorney for financial, medical and legal advice.
obgyn65 is offline   Reply With Quote
Old 09-24-2010, 06:40 AM   #55
Thinks s/he gets paid by the post
 
Join Date: Dec 2004
Posts: 1,798
Quote:
Originally Posted by M Paquette View Post
That's just the opening. In California, one of the affected states, there is already a bill on the Governor's desk to require that any firm selling that lucrative individual medical insurance in the state also sell individual policies for children.

Call and raise...
What's to keep the insurance companies from selling the child policies but at say $10 or $20K per year and still complying with the law?
__________________
You don't want to work. You want to live like a king, but the big bad world don't owe you a thing. Get over it--The Eagles
lets-retire is offline   Reply With Quote
Old 09-24-2010, 06:42 AM   #56
Thinks s/he gets paid by the post
 
Join Date: Dec 2004
Posts: 1,798
Quote:
Originally Posted by NW Landlady View Post
Here is a comparison online (take it with usual grain of salt) by country. Note the $ per capita difference between US & other countries with better healthcare: Healthcare Costs Around the World |
What year is that data from? I'm not really familiar with the website you posted and it is interesting that it is very different than the data presented by the WHO.




I'm going to try to stay out of the rest of this discussion, since it normally gets me a bit irritated at the distortions and outright misinformation.
__________________
You don't want to work. You want to live like a king, but the big bad world don't owe you a thing. Get over it--The Eagles
lets-retire is offline   Reply With Quote
Old 09-24-2010, 09:42 AM   #57
Recycles dryer sheets
 
Join Date: Aug 2007
Posts: 401
Quote:
Originally Posted by ERD50 View Post
Yes, I was surprised how little attention the Swiss system got in this whole debate leading up to what we got. I could be 'sold' on the Swiss system, and I'm a tough 'sell'.

Makes me wonder - how did the Swiss manage to do it?

-ERD50
Switzerland only has about 8 million people. I'm guessing that it's alot easier changing something when you're dealing with a population that small (as compared to the US with over 300 million people).
__________________
DallasGuy is offline   Reply With Quote
Old 09-24-2010, 09:47 AM   #58
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,260
Quote:
Originally Posted by DallasGuy View Post
Switzerland only has about 8 million people. I'm guessing that it's a lot easier changing something when you're dealing with a population that small (as compared to the US with over 300 million people).
That probably is a big factor. It is also why I think the statements about how we pay more and get less for our HC dollar are a bit misguided (though true). It's partially due to trying to meet the 'needs' of a very large and diverse society. I'm not sure there is anything substantive to say that changing the US system to a more public one is going to change that.

-ERD50
__________________
ERD50 is online now   Reply With Quote
Old 09-24-2010, 10:02 AM   #59
Thinks s/he gets paid by the post
Gotadimple's Avatar
 
Join Date: Feb 2007
Posts: 1,760
Quote:
Originally Posted by lets-retire View Post
What's to keep the insurance companies from selling the child policies but at say $10 or $20K per year and still complying with the law?
Their state insurance commissioner. Any politician running for election.

-- Rita
__________________
Only got A dimple, would have preferred 2!
Gotadimple is online now   Reply With Quote
Old 09-24-2010, 10:31 AM   #60
Thinks s/he gets paid by the post
 
Join Date: Dec 2004
Posts: 1,798
Quote:
Originally Posted by Gotadimple View Post
Their state insurance commissioner. Any politician running for election.

-- Rita
The same pressure can be brought to bear against the state for health insurance that can be brought to bear against the states surrounding the Gulf of Mexico. The insurance companies can just as easily say, "OK, fine we just won't offer health insurance." They typically make less than 5% on health insurance anyway. It won't kill the company to not offer insurance in a state.
__________________

__________________
You don't want to work. You want to live like a king, but the big bad world don't owe you a thing. Get over it--The Eagles
lets-retire is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Healthcare Reform... What Next? chinaco FIRE Related Public Policy 40 01-31-2010 12:21 PM
Healthcare reform article Stevewc FIRE Related Public Policy 81 08-25-2009 11:21 AM
Healthcare reform - a wave of early retirees? FinanceGeek Health and Early Retirement 51 07-02-2009 06:12 PM
Retirees may worry about healthcare reform lightwaves FIRE and Money 10 06-20-2009 01:34 PM
Colorado Healthcare Reform - New Proposal mykidslovedogs Health and Early Retirement 9 06-06-2007 08:34 AM

 

 
All times are GMT -6. The time now is 03:00 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.