No Politics, HC big issue for FIRE

Who's the administrator or insurer of that MA PPO?
 
Montecfo said:
I agree the problem is not profit, it is structure. Name another product or service routinely bought and sold with neither provider not recipient knowing the price.

Can't expect good value without price transparency.
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+1
Absolutely correct. Time Magazine did a great story on this issue a few years ago.
 
Montecfo said:
I agree the problem is not profit, it is structure. Name another product or service routinely bought and sold with neither provider not recipient knowing the price.

Can't expect good value without price transparency.
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hesperus said:
+1
Absolutely correct. Time Magazine did a great story on this issue a few years ago.
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Problem is, you're not often going to have a chance to price-shop.

If you're in an emergency situation, are you going to look up what different emergency rooms charge on your phone while you're in the ambulance?

Even in a non-emergency situation, if you're hit with a serious diagnosis, are you going to shop by price or the reputation/perceived quality of a doctor or hospital?

Many would say health care demand is price inelastic. That is people are going to want to save themselves or their loved ones, even if the cost is high.

That may be why ultimately, the same kind of free market dynamics which govern for instance the price of corn may not apply to health care.
 
explanade said:
That may be why ultimately, the same kind of free market dynamics which govern for instance the price of corn may not apply to health care.
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If there was a mandated cap, of say $250 per month, with a $1500 deductible, Insurers could go to the hospitals and negotiate prices knowing that was all they had to offer.

Hospitals would monitor their costs to meet the anticipated revenues. Some workers would retire early, some would stay on. If there was a greater supply of workers, this could be done.
 
explanade said:
That may be why ultimately, the same kind of free market dynamics which govern for instance the price of corn may not apply to health care.
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The same kind of dynamics definitely don't govern the prices of corn and health care. Just to mention a few differences that are critical

Buyers of corn can choose to buy or not, and can substitute corn with another food product. Health care only has two substitutions - no health care or health care from a different provider.

Buyers and sellers of corn have the same information and can make an equally informed decision to buy or sell. Providers of health care (physicians and pharmacists) have knowledge that patients do not have. Knowledge equality is a fundamental characteristic of the "invisible hand".

Corn is not unique, a buyer can compare offers from different sellers and look for the most competitive price. Prospective users of health care cannot compare the services offered by providers.

Corn prices are not hidden with confidentiality agreements. The price quoted is the price paid, and while prices may differ between transactions, they are similar. Health care prices are undisclosed, providers do not disclose them, prices may differ from one patient to another.

If corn prices rise, farmers can plant more and in a short period of time bring more supply to the market. Health care supply and regulation is carefully controlled by the industry, this leads to artificial restriction of supply.

Looking around the world, there is not one single approach countries use to deliver adequate care to all it's residents, but there is no developed country that has a "free market" approach to health care.
 
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My BIL and SIL, niece and nephew live in a tiny village in the Dolomite Mountains in Italy about an hour from Bologna. We've visited many times over the years. People live on their own into the 90's. They walk the mountains, they carry groceries, they live simple lives and eat fresh food produced in the right time of year. They care for each other, check on each other every day or every few days. Many elderly live alone, but the community is there. Their needs are minimal but they enjoy wine, fresh pasta, vegetables and communicate with each other, sit and play cards, talk, share coffee and pastries. It's a slower life, but a longer life.

No one can tell me that cannot be done here. We have vast resources to simulate this lifestyle. America grew up too fast. New houses might last 30 years, maybe 40 without a major remodel or teardown. What happened to the simple life? My SIL and family live in a 200 yr. old house and it's on the newer side.

Healthcare is not "free" in Italy because they pay higher taxes. But no one pays directly for medical care. No one goes bankrupt from a medical issue. Careful planning goes into finances and the retirement age is rising.

I consider that way of living wise. Why must we be busy every minute of the day?
 
Again, Single Payer works. BUT for some reason we are so afraid of the "T"(ax) word, that we seem to be very happy to give way more money to an Insurance company than pay 1/5th the amount we give them in extra taxes. It really does not make sense to me as one who has actually experienced 2 single payer systems before emigrating to the USA. What the difference is between a profit based company making decisions on our healthcare, than a single dedicated funded government department making them is, I do not know.
 
ShokWaveRider said:
Again, Single Payer works. BUT for some reason we are so afraid of the "T"(ax) word, that we seem to be very happy to give way more money to an Insurance company than pay 1/5th the amount we give them in extra taxes. It really does not make sense to me as one who has actually experienced 2 single payer systems before emigrating to the USA. What the difference is between a profit based company making decisions on our healthcare, than a single dedicated funded government department making them is, I do not know.
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There are so many examples of government waste, that it would take too long to answer this. It's a fundamental or dare I say, ideological difference I think as to who can take care of the market place better, government or private...
 
Pilot2013 said:
There are so many examples of government waste, that it would take too long to answer this.
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Implicit in that statement is that the private sector is less wasteful than government. IME, that's not true, the private sector is just subject to less oversight.
 
ncbill said:
I love the idea of single payer, but everyone does understand how they have to operate to at least try to remain solvent?

There is always some form of gatekeeper deciding whether or not the plan even covers a specific treatment or medication.

Such a plan would never cover those "live a few months longer with your advanced cancer by paying 6-figures for our medication" treatments seen advertised on TV here in the U.S.

I believe covering the most people at the lowest cost makes that an acceptable trade-off, but it's clear reading the posts here many would not agree.
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pb4uski said:
+1 essentially "society" would make those difficult decisions since "society" is paying for it... hopefully balancing humanity and economics..... that would be fine with me as I believe that we spend too much trying to prolong life where there is poor quality of life.... and those who have the means and want to spend their money on expensive treatments to prolong their life a little would be free to do so if they wish.
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Hence, most countries with universal healthcare allow supplemental insurance so people who want to pay for additional care can get it, whether it really helps them live longer or not. Hope springs eternal. It's a reasonable solution, I think.
 
ShokWaveRider said:
The Private system will ONLY work if it is NOT FOR PROFIT.
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You are absolutely right. Still, it is questionable even with 'not for profit' organization, not long ago I read that Goodwill CEO get paid million(s). Hmm, my donation helps pay that guy.
 
neihn said:
You are absolutely right. Still, it is questionable even with 'not for profit' organization, not long ago I read that Goodwill CEO get paid million(s). Hmm, my donation helps pay that guy.
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How much should the CEO of an organization with 100,000 employees and revenue of $3 billion dollars get paid? I don't have the answer, but not for profit doesn't mean no salaries.
 
I'm not even going to offer my opinions. A lot of them have already been covered.

I just think it's great that we're able to have a civil discussion, without the usual politics around this subject. In the US today, this sort of debate usually ends up as nothing but name-calling and hurling around empty (and often untrue) talking points.

There ARE facts out there, and varying degrees of opinion about which are most important. If everyone interacted like this, we COULD solve this problem.
 
jimbee said:
How much should the CEO of an organization with 100,000 employees and revenue of $3 billion dollars get paid? I don't have the answer, but not for profit doesn't mean no salaries.
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I wonder that too, however, keep in mind that all that revenues came from donations.
 
CaptTom said:
I'm not even going to offer my opinions. A lot of them have already been covered.

I just think it's great that we're able to have a civil discussion, without the usual politics around this subject. In the US today, this sort of debate usually ends up as nothing but name-calling and hurling around empty (and often untrue) talking points.

There ARE facts out there, and varying degrees of opinion about which are most important. If everyone interacted like this, we COULD solve this problem.
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Well I blame the stupid Republicans... no wait that's not right.

Oh yeah, I blame the dopey Democrats... no wait that doesn’t sound right either.

I know, it is the idiot Independents that should be boiled in oil... darn, that still hits me as wrong.

Got it. Like Shakespeare said, "kill all the lawyers"!

Guess I’ll have to leave it there...
 
NW-Bound said:
Hence, most countries with universal healthcare allow supplemental insurance so people who want to pay for additional care can get it, whether it really helps them live longer or not. Hope springs eternal. It's a reasonable solution, I think.
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Agree. Universal single payer to cover the basics and if you want more (or faster) you pay for it. Effectively that’s how it works in Canada. If we want more we can just drive across the border to the US and pay for it. It’s surprisingly inexpensive to pay cash for “a la carte” service.
 
Pilot2013 said:
Is there really a case where someone is absolutely refused lifesaving care due to no insurance? I have always been under the impression that part of the reason our HC insurance and medical costs are so high is that they have to cover the uninsured through the insured and paying?
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depends on how you classify, life threatening... if you don't treat diabetes, chrones, asthma, cancer, cystic fibrosis, etc, you will die eventually; however, does that mean they have to provide you the meds and ongoing care to make sure it doesn't get to that point? I know before the ACA people were on heart transplant lists that had hearts but didn't have the money to pay for the transplant and were denied and died. ie I had always assumed one of the biggest reasons HC insurance was so high was because people had to wait till they were dying to get treatment, vs. getting the meds/care to treat the disease so it never got to that point. Now I know there are people in the ER these days just to get prescriptions, we live in a non-expended medicare state, so I'm assuming those people do not have insurance and are getting 'basic" care via the ER still.

I know this because when I went to the ER last year, they asked if I was there to get a script...and, of course, I was bewildered by the question.. ie who in the world would go to the ER to get a script.. OHHHH.wow. very enlightening trip. BTW, was told not to go to the ER on Mondays if I could avoid it, um yeh because I plan my ER trips, took 12 hours before I was seen and only there because Urgent care couldn't treat me and had to refer me over.
 
NW-Bound said:
Hence, most countries with universal healthcare allow supplemental insurance so people who want to pay for additional care can get it, whether it really helps them live longer or not. Hope springs eternal. It's a reasonable solution, I think.
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Supplemental insurance seems like a no-brainer with medicare. 1) Sign up for medicare, 2) get supplemental F (or is that now G?) plan, 3) don't worry about unexpected surprises.

Wonder why no such market is considered for non-medicare insurance.

Who knows maybe such a market will happen if the ACA mandate is gone and health insurance becomes optional :(.
 
REWahoo said:
I like it.

You could order an appendectomy online and a Dr. could show up at your house within two hours, let himself in using a special door code, and do the surgery on your kitchen counter. The reduced overhead cost would allow for a huge savings!
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If Amazon have anything to do with it, a drone will show up to your house and perform the surgery via remote control :LOL:


Pilot2013 said:
Yes. I'd love to save everyone..... I'll stop here to avoid Porky.
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There's a way to talk about emotive subjects like this one, without inviting Porky, if you take a little time to think about it. This thread has already covered the subject of "gatekeepers" who decide what procedures will and won't be covered. That happens regardless of how the coverage is paid for. It's very legitimate, IMO, to talk about an overall "wellness" approach involving greater education and other systemic approaches to encourage folk to live more healthily.

I think it was my brother-in-name, Capt Tom, who expressed pleasant surprise at how this subject has been discussed here without serious discord. I concur. It's really great to see an intelligent discussion that doesn't deteriorate into name calling and broad generalizations. Another reason I need to spend less time on FB!
 
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