5
0

Health care costs ...Too much GOVT is the problem.


 invite response                
2012 Dec 16, 4:24am   27,918 views  91 comments

by chanakya4773   ➕follow (1)   💰tip   ignore  

Here is my take on the root cause of Healthcare cost in USA. I am focusing on costs because focusing on redistributing the costs ( which is mainstream media focus) does not fix the problem.

Fact : Healthcare cost is rising significantly faster than inflation in USA.

Reason : Given that health care is not a new industry and such a broad industry, the only reason for this divergence can be that its not a "FREE MARKET". In any free market, a broad established industry's "long term" inflation is always inline with rest of the economy.

Analysis : My whole analysis will be to focus on why its not a "FREE MARKET"

Divergence from free market happens primarily because GOVT comes in between consumer and services/goods provider. Generally, once the GOVT gets involved, a third party will use its lobbying power to influence the industry ( through GOVT) to its own advantage .

1) Insurance (GOVT SUBSIDIES and MANDATES) :
PROBLEM : GOVT + INSURANCE LOBBY:
Govt subsidizes health insurance ( In 1954 Congress codified this practice into the tax code ). This forced people to go through the insurance system because subsidies slowly destroyed cash driven non insurance based payments. NON catastrophic insurance is a flawed system because it makes everybody price insensitive. Since insurance pays the costs and is a pool system, nobody cares what the health industry is charging them.
imagine if insurance pays for your grocery store purchases.We will buy excessively things we don't need and waste everything.The grocery store charges will be excessive as well. There are some market forces at play here though. if the wastage goes up, insurance premium goes up and we chooses an insurance which has less premium.This creates motivation for insurance company to control costs.
But this cost control mechanism is not as efficient as free market though. its akin to soviet style centralized system versus free market capitalist system to control costs. insurance itself is a in-efficient system and should only be used for protection against catastrophic events where it serves an important function.In a free market , hospitals strive to have good reputation and offer services for low prices to attract consumers. The latter part is definitely not happening because the consumer is not price sensitive

Cosmetic surgery does not have insurance system and you can see the difference between regular industry versus cosmetic industry. The advancements in cosmetic surgery are at par with other areas of medical fields but at reduced cost because market forces are at work.

SAME WITH LASIK which is not covered in insurance.

2) GOVT PROTECTED Licensing of doctors and nurses and PROTECTIONISM:
PROBLEM = GOVT + DOCTORS/NURSES/DRUG lobby :
Licensing Doctors means that doctors need the permission of govt to provide their services. This system was not a big issue long time back when there was no globalization. As globalization started, most of the goods and services started to get cheap. Goods got cheaper because of stuff getting manufactured in foreign countries and services got cheap due to immigrants filling lot of positions. Most of the farm jobs were taken by farm labor from mexico. Engineering jobs were primarily filled with immigrants as well. This phenomenon didn't happen in medical field but only happened in field where there is no licensing needed for services ( like farming, engineering , restaurants..etc). Licensing enables protectionism. Since most of the functions of medical field are licensed including doctors, nurses and hospitals, they are protected from globalization and competition from foreign doctors/nurses who want to practice in US. This disparity caused medical field to look more expensive RELATIVE to the other fields. In essence the US consumer is not getting the benefit of cheap international labor in medicine . This probably is not the complete story and i am guessing more components of the medical bill are protected from market forces like prescription drugs..etc.
Licensing also forces some arbitrary body to decide what kind of service providers the consumer needs.If it were a free market, the market will decide what kind of training the doctors need to satisfy the demand.The salaries will also be based on the market prices. If the society is not rich , it will decide to go for doctors who are trained cheaper ( like in India). ofcourse, the quality will be lower but that's what the society can afford and is most effective. people who can afford higher quality will choose a doctor with more training. Its a self correcting system. in car industry, some consumers buy honda civics and some consumers buy a Porsche.IF govt mandates that people only buy cars with standards of porshe, most consumers will have to take public transportation because they cannot buy civic and cannot afford Porshe. Current licensing system forces a over trained doctor down the throat of consumers. actually a third party licensing body would never be able to decide what training is most effective to consumers just like soviet style centralized planning could never decide what products are needed by citizens. Free market is the answer.
Certification is better than licensing as it informs the consumer of the choices but does not force a particular choice. Hospitals will always choose the doctors with the right certification for the right job without being dictated by a licensing body. this will drive down prices.hospitals will also vet the doctors to save hospitals reputation.

from wikipedia http://en.wikipedia.org/wiki/Health_care_in_the_United_States#Licensing_of_providers: "American Medical Association (AMA) has lobbied the government to highly limit physician education since 1910, currently at 100,000 doctors per year,[111] which has led to a shortage of doctors[112] and physicians' wages in the U.S. are double those in the Europe, which is a major reason for the more expensive health care.[113]"
113: http://reason.com/archives/2009/08/27/the-evil-mongering-of-the-amer

3) Mandating Emergency services (GOVT MANDATES) :
PROBLEM : GOVT + FREE LOADERS - Vote bank:
The day Govt mandated emergency services to general public , it created a huge sink hole in the system. Mandating hospitals to perform any services to general public irrespective of their ability to pay means in essence they are forcing some people to pay for other peoples expenses. When a hospital is performing a emergency service and the consumer does not pay it, the hospital passes on the expenses to other people. Anytime you create a system where the consumer does not have to pay himself , he becomes price insensitive and this creates lots of waste. Most countries don't have this kind of mandates. Also this creates incentive for too many people coming to emergency services instead of getting care early on which could have reduced the overall medical cost for the society.
In the absence of Govt mandate, new charity based hospitals ( partially funded by govt or private) will pop up ( like pre insurance period of 1930's) and give some form of cushion to the most needy.
MANDATING ONE PERSON TO PAY FOR ANOTHER PERSON'S EXPENSES IS NEVER A GOOD IDEA. Be it through insurance mandates, court system ( malpractice litigation expenses) or hospitals ( mandating emergency services)

4)Medical Malpractice insurance costs (GOVT forcing other people to pay a litigation winner -through malpractice insurance ):
PROBLEM : GOVT + LAWYERS LOBBY :
Giving Patients the option to Waive certain Rights to Sue for Medical Malpractice for certain services is important to address this issue. Since Medicine is not an exact science and involves considerable risk, GOVT cannot force everybody to pay for the costs of not being perfect. In essence the GOVT through their court system is forcing doctors to work overtime to make a service more risk free than its possible. after certain point there are diminishing returns in trying to reduce risk.I have heard stories that some doctors spend more time filling paperwork/unnecessary expensive tests than actually treating patients. There is some inherent risk in certain services and patients should have the option of allowing the doctors to take the risk so that the patient can get the service from doctor at reduced cost. of course driving a car involves risk but that does not mean we force all the car manufactures to design risk free cars. even if its designed, it will be unaffordable by many consumers. Another aspect of the medical malpractice is the money awarded by the courts.
The primary focus of the court system should be to create incentive for the hospitals to reduce recklessness and malpractice which can be accomplished by other punitive measures rather than awarding large sums of money to patients. example: you can suspend a doctor from practicing if he does some fraud/malpractice rather than award 1 million dollar to the patient ! The focus should be to reduce fraud not make the attorney's rich.ofcourse the money awarded should be reasonable so that attorneys are motivated to take the case but it should not be ridiculous amounts since we all have to bear the cost.

AT THE END OF THE DAY EVERYBODY IS RIPPING OFF HARDWORKING MIDDLECLASS-INSURANCE-PAYING AMERICANS.

SOLUTION WHICH WILL WORK : FREE MARKET PRIVATE HEALTH CARE SYSTEM for the majority and GOVT OR CHARITY RUN HOSPITALS FOR THE POOR AND NEEDY.

« First        Comments 16 - 55 of 91       Last »     Search these comments

16   Peter P   2012 Dec 16, 12:12pm  

chanakya4773 says

We can always have insurance for catastrophic medical events. insurance for doctors visit ..etc does not make sense. Insurance should be only used for events which backrupt people and nothing else because insurance is a very in-efficient system. even in single payer universal health care system, it should be the case.

Ideally, yes. Let's see how much costs can be lowered. People should not have to spend $20K on scans and tests.

BTW, one more important thing: TORT REFORM.

17   JohnLaw   2012 Dec 16, 12:53pm  

Peter P says

Yet healthcare is something as problematic as national defense for the market to handle.

I completely disagree. Before the 30s there wasn't even such a thing as healthcare insurance. As a matter of fact, healthcare in the USA was totally private until 1965. Nobody was dying in the streets and there were numerous private, charitable organizations that took care of the poor.

18   Homeboy   2012 Dec 16, 2:15pm  

chanakya4773 says

WHEN DID WE TRY FREE MARKET SYSTEM ???
WE NEVER HAD ONE AND NEVER TRIED ONE

What the hell are you talking about? Are these government entities? No.

Unitedhealth Group
Wellpoint Inc. Group
Kaiser Foundation Group
Aetna Group
Humana Group
HCSC Group
Coventry Corp. Group
Highmark Group
Independence Blue Cross Group
Blue Shield of CA Group
Cigna Health Group
BCBS of MI Group
Health Net of California, Inc.
BCBS of NJ Group
BCBS of FL Group
Regence Group
BCBS of MA Group
Carefirst Inc. Group
Wellcare Group
HIP Ins. Group
Metropolitan Group
Unumprovident Corp. Group
Universal Amer Fin Corp. Group
Lifetime Healthcare Group
BCBS of NC Group

Your "idea" of removing all licensing requirements is utter insanity. How would there be any protection at all against "doctors" who are incompetent, scam-artists, etc? There have even been cases of doctors raping their patients, literally. I certainly would not want someone like that to still be able to practice medicine. For god's sake, you need a license to DRIVE A CAR, but you don't think people should have a license to render you unconscious and cut into your body with knives?

Ridiculous. Yes, we have for-profit medical insurance and hospitals. They get greedy and start overcharging so they can make obscene profits. It doesn't work. Not everything can be fixed by the free market. The military, roads, environmental protection, police, firefighting, etc. are not effectively handled by the free market. Nor is healthcare.

19   Homeboy   2012 Dec 16, 2:17pm  

JohnLaw says

I completely disagree. Before the 30s there wasn't even such a thing as healthcare insurance. As a matter of fact, healthcare in the USA was totally private until 1965. Nobody was dying in the streets and there were numerous private, charitable organizations that took care of the poor.

Boy the way Glen Miller played
Songs that made the hit parade.
Guys like us we had it made,
Those were the days.

And you knew who you were then,
Girls were girls and men were men,
Mister we could use a man
Like Herbert Hoover again.

Didn't need no welfare state,
Everybody pulled his weight.
Gee our old LaSalle ran great.
Those were the days.

20   Homeboy   2012 Dec 16, 2:19pm  

chanakya4773 says

you are wrong. there will be charity based hospitals which will pop and atleast not allow people to die

Sure, just like magic.

21   Homeboy   2012 Dec 16, 2:23pm  

chanakya4773 says

why do you have problem with certified doctors versus licensed doctors ?
you are free to go to CERTIFIED doctors who are trained according to your standards but allow other people to go to doctors who are trained differently

What the fuck are you babbling about now? You wrote that you don't think doctors should have to have a license, and I said they should. Don't confuse the issue with gibberish.

Do you honestly believe a hospital with good reputation will hire a doctor who is butchering people. Its a self correcting system. Hospital will only hire doctors who are best suited for the jobs without ruining hospitals reputation. Some third party ( like AMA) does not dictate the choice.

No, it's not a "self-correcting" system. What evidence do you have that it is?

Like I said, you are free to move to a 3rd world country if you are so intent on having incompetent doctors.

22   bob2356   2012 Dec 16, 2:26pm  

chanakya4773 says

India is one example where there is very little govt intervention and there is literally no insurance system

That's odd, I googled health insurance in India and got like 8-10 pages of companies selling health insurance in India. Could you please explain this minor discrepancy? Also I know for a fact that India has a public health care system, I've been there and talked to people involved in it. Is this also part of the free market?

India has 1 doctor for every 2000 people vs 1 per 300 in the us. The average Indian travels 77km to see a doctor. I'm not sure you could really hold this up as an example of health care US should be emulating. Care to try again?

23   bob2356   2012 Dec 16, 2:29pm  

chanakya4773 says

I am sure US was probably more free market driven in early 1900's when there was no insurance system.

Average life span was 36, would you like to go back?

Health insurance actually dates back to the civil war and became common in the 1930's. Is google not working on your computer? http://www.randomhistory.com/2009/03/31_health-insurance.html

24   Homeboy   2012 Dec 16, 2:34pm  

chanakya4773 says

Homeboy says

chanakya4773 says

you are wrong. there will be charity based hospitals which will pop and atleast not allow people to die

Sure, just like magic.

Don't you read the posts before jumping in to conclusions.
Did you read the post by Johnlaw :

I completely disagree. Before the 30s there wasn't even such a thing as healthcare insurance. As a matter of fact, healthcare in the USA was totally private until 1965. Nobody was dying in the streets and there were numerous private, charitable organizations that took care of the poor.

even Ron paul said the same thing during republican primaries.

Yes, I read things and I ALSO determine if they are relevant to what I wrote. Do you? I still don't see any proof from you that the poor will magically be taken care of if the government doesn't.

Just because something was the case in the past does not mean it should be so now. Have you forgotten that we also had slavery and child labor. Did the "free market" fix that?

25   Homeboy   2012 Dec 16, 2:37pm  

bob2356 says

Average life span was 36, would you like to go back?

Health insurance actually dates back to the civil war and became common in the 1930's. Is google not working on your computer? http://www.randomhistory.com/2009/03/31_health-insurance.html

Tee hee. You just got pwned, chanakya.

26   bob2356   2012 Dec 16, 2:39pm  

chanakya4773 says

We can always have insurance for catastrophic medical events. insurance for doctors visit ..etc does not make sense. Insurance should be only used for events which backrupt people and nothing else because insurance is a very in-efficient system. even in single payer universal health care system, it should be the case.

The first logical statement you've made. Health insurance should be catastrophic.

Single payer and universal/public heath care are very different things. Public health care is not insurance in any way shape or form.

27   bob2356   2012 Dec 16, 2:43pm  

chanakya4773 says

Also, like JOHNLAW mentioned US was also mostly insurance free before 1965 so you don't have to go too far to look.

bob2356 says

Health insurance actually dates back to the civil war and became common in the 1930's. Is google not working on your computer? http://www.randomhistory.com/2009/03/31_health-insurance.html

You're not paying attention.

chanakya4773 says

India is one example where there is very little govt intervention and there is literally no insurance system.

chanakya4773 says

There are lot of private health care insurance companies in india but 90% people don't use them

These don't seem to be complimentary statements.

28   Homeboy   2012 Dec 16, 2:45pm  

chanakya4773 says

When govt started subsidizing insurance is when the problem started.

What do you mean, "when government started subsidizing insurance?" When did the government start subsidizing insurance?

29   Homeboy   2012 Dec 16, 2:46pm  

chanakya4773 says

What the fuck are you talking about. can you explain why it worked in the past and it won't work now ?

It DIDN'T work. Are Bob's posts not showing up on your computer?

30   bob2356   2012 Dec 16, 2:48pm  

Homeboy says

chanakya4773 says

When govt started subsidizing insurance is when the problem started.

What do you mean, "when government started subsidizing insurance?" When did the government start subsidizing insurance?

He's talking about when it became tax deductable to businesses in 1954 or so. Since he isn't a brilliant student of history he isn't aware that health care insurance exploded during WWII because of wage freezes. Health care insurance was offered instead of raises. But why let facts get in the way?

31   Homeboy   2012 Dec 16, 3:08pm  

Here's your golden age of medicine before they started bothering with silly things like licensing:

Once it was easy to become a doctor. During the nineteenth century the United States saw the emergence of an estimated four hundred proprietary medical schools. Set up to offer medical degrees as part of profit-making ventures, these schools generally had low standards of instruction, poor facilities, and admitted anyone who could pay the tuition. Since the proprietary schools competed with so many other for-profit schools as well as schools affiliated with universities, they advertised incentives to get students for their programs. One school gave free trips to Europe upon graduation to any students who regularly paid fees in cash for three years. Anyone who had the money could get a medical degree and practice medicine. In many of the private proprietary schools, degrees were granted after one year of courses that consisted chiefly of listening to lectures.

http://www.encyclopedia.com/doc/1G2-3468300573.html

32   Homeboy   2012 Dec 16, 3:13pm  

1900s:

Most medical schools operated primarily for the benefit of their physician-owners and lacked libraries, laboratories, or even much clinical experience for students. Hospitals were few in number, located only in the largest urban areas, and served primarily the poor. Most surgeries were still done in the home. The nation was flooded with ineffective and sometimes dangerous patent medicines sold directly to the public by charlatans. Diseases such as yellow fever, typhoid fever, tuberculosis, pellagra, and hookworm ravaged entire communities. Government support of health care initiatives was weak at best.

http://www.encyclopedia.com/doc/1G2-3468300224.html

33   Homeboy   2012 Dec 16, 3:14pm  

1910s:

Unhealthy Americans

The growing emphasis on medical examinations in the 1910s revealed that most Americans had some kind of health problem. Of 3.76 million men examined for service in World War I, about 550,000 were rejected as unfit; and of the 2.7 million called into service, about 47 percent had physical impairments. In one study examining 10,000 workmen, not one was reported in perfect health. Ten percent were slightly impaired, and the other 90 percent were in varying stages of poor health: 41 percent had problems requiring minor treatment; 35 percent had conditions requiring medical supervision; 9 percent had serious physical impairments requiring systematic treatment; and 5 percent had grave problems requiring immediate medical attention. Among 5,000 citizens of Framingham, Massachusetts, examined as part of a Metropolitan Life Insurance demonstration project to control tuberculosis, 77 percent were recorded as ill with some disease; two-thirds of the defects discovered were supposedly preventable. But Americans did not see themselves as unhealthy. The physicians' examinations found twelve times as much illness as did a house-to-house survey of self-reported sickness.

http://www.encyclopedia.com/doc/1G2-3468300562.html

34   Homeboy   2012 Dec 16, 3:14pm  

You want to go back to that, huh?

35   Homeboy   2012 Dec 16, 3:21pm  

bob2356 says

He's talking about when it became tax deductable to businesses in 1954 or so. Since he isn't a brilliant student of history he isn't aware that health care insurance exploded during WWII because of wage freezes. Health care insurance was offered instead of raises. But why let facts get in the way?

So he's saying that all healthcare problems started in the 1950s? Because this is how it was in the 1930s:

In the 1930s the biggest health concern of America was how to pay for medical needs. The national income was less than half of what it had been in 1929, and in several states as many as 40 percent of the people were on relief. Many Americans could not pay their medical bills, and visits to physicians and hospitals decreased. Before the Depression, physicians charged a fee-for-service on a sliding scale and collected their bills as best they could. They also saw some patients on a charity basis and passed the expenses along to those who could pay. Loss of medical services and reduced ability to pay meant lower incomes for physicians, too. While doctors as a group fared better than many other professions during the Depression, in many cases they also saw their incomes halved. Hospitals were in similar trouble. Beds went empty as patients could no longer afford a two-week hospitalization, which was the average in 1933. Bills were unpaid, and charitable contributions to hospital fund-raising efforts fell.

http://www.encyclopedia.com/doc/1G2-3468301278.html

Doesn't exactly sound like a utopia to me.

36   Homeboy   2012 Dec 16, 4:56pm  

chanakya4773 says

What does all this have to do with licensing versus certification.
There was lot of disease before and its common knowledge...nothing rocket science. Technology and science has advanced quite a lot and improved things including health care. The aircrafts today are much safer than the once in early part of 1900s. It didn't happen because aircraft engineers were licensed versus cerified. it happened because of the progress in the field just like any other field. every field including medicine has advanced. there is no licensing in engineering but it still advanced. Do you think all the software engineers are licensed. why the heck then software field is advancing so fast ?

Did you not read the excerpt about how poor physician training was in this period of history that you seem to think was some sort of utopia that we should strive to return to? What's difficult for you to understand about that?

Software engineering is a very poor analogy to medical practice. Among many other things, if you botch a computer program, people simply won't buy it. If you botch surgery, you kill the patient. Free markets work great for some things, but not at all for others.

37   Homeboy   2012 Dec 16, 5:04pm  

chanakya4773 says

how could have insurance system solved this problem ? this was a depression problem not a health industry problem.

You are turning things around. I did not claim that health insurance could solve this problem. YOU are the one claiming that a cash-for-service system would solve all problems. YOU stated that you believe the U.S. should return to whatever we were doing pre-1950s, because of your belief that it worked so well. But I have proven that it did NOT work well, hence your argument is not valid.

It is YOUR claim that government intervention is the source of all problems with the healthcare system in the US. I am simply disagreeing with your premise.

38   bob2356   2012 Dec 16, 8:16pm  

chanakya4773 says

India is one example where there is very little govt intervention and there is literally no insurance system

chanakya4773 says

The public health care system is for the poor and needy and is directly run by govt. its a very small percentage of the total hospitals that india has

Your statements. Very little government intervention. Yet 1.2 billion people are covered by the public health care system and depending on whose number you believe 35-40% use it for their health care. So 480 million people using the public health care system represents very little government intervention??? Really???

chanakya4773 says

THERE ARE NO MANDATES ON PRIVATE HOSPITALS AND DOCTORS in india. The private industry is fully free market based.

Maybe you should read a little. Try transition.usaid.gov/in/our_work/pdfs/promise_reality.pdf for a starter. I read the whole paper about 5 years ago (it was a very, very long flight). Lots of interesting tidbits about government regulations on hospitals in India. Try page 40 hospital reimbursement by source. Let's see, 41% government, 35% insurance, 17% employer, 7% other/cash. If you care to read a little further you will find the 17% employer is from government mandated health insurance coverage in certain industries and self insurance by corporations with tax and other government incentives (page 84). So 41% of reimbursements to the hospitals by the government is "a very small percentage"???

Maybe it would be best if you discarded and drew new cards. What other country would you like to point to as a free market medical system?

39   lostand confused   2012 Dec 16, 8:35pm  

bob2356 says

Your statements. Very little government intervention. Yet 1.2 billion people are covered by the public health care system and depending on whose number you believe 35-40% use it for their health care. So 480 million people using the public health care system represents very little government intervention??? Really???

Well there is a difference between a roach infested motel in a crime ridden neighbourhood and Ritz Carlton in a nice neighbourhood. The former may be free-but do you want to stay there with your family.

In the US, the latter can be used by people with insurance and poor/illegals who just walk into the emergency room and get treated for free. The middle class-they can come after your assets. But the poor/illegals are judgment proof-they have no assets. So there is a difference with the mandates.

Now I understand the rationale, if you are in a car accident, or have a heart attack, the last thing you need is to be tossed aside by the emergency room, because you have no proof of insurance-you might have left proof at home. So that is a big problem. But hospitals do run up a big tab and the rest of us pay for it.

However I read somewhere that India is giving free generic prescritpon drugs to all of its 1.2 billion citizens, don't know if the law passed yet.

40   JohnLaw   2012 Dec 16, 9:47pm  

Bottom line is that the 51% found that they can use the government as a means of extortion. For now, they think that all of their needs can be achieved by this and life will be better as a government serf. We shall see.

41   bob2356   2012 Dec 17, 3:47am  

chanakya4773 says

and you still believe GOVT is not a problem and you are a free citizen.
this is the worst form of tyranny.

Where did anyone say that the US government wasn't one of the problems with US health care, one of many? No one said anything even close to that. Try to read more carefully. Everyone is saying that your free market idea doesn't work either. If it does then please show us where it exists. India sure isn't it.

Why is the government forcing you to do any of these things? You are free to not have health insurance, just pay the penalty, No health insurance then the subsidy doesn't matter to you. No health insurance no payment for er's for you. No health insurance no payment for litigation for you. You are free to travel to any free market hospital in the world for your care. You don't even need a doc, just use the internet. You have all the access you want to foreign doctors, just cross the border.

Why are you and john law always a matched set of comments together? Curious coincidence.

42   bob2356   2012 Dec 17, 3:20pm  

chanakya4773 says

My idea of having a free market health care system and govt run hospitals for the poor and needy will work.

WTF???? After ranting against government involvement in health care for 20 or 30 posts now you want government run hospitals? Did you log onto the wrong profile by accident?

So where does this utopian free market health care exist? Got an example? I'd love to see it. Since 93% of the hospital income in India comes from government or insurance I really don't think you can say it's a free market.

chanakya4773 says

Do you think a person living in utah will cross the border to get a doctors visit. please me more practical.

You have the option, if it's practical is a different issue. Tyranny is when the government closes the boarders so you can't leave and confiscates your paycheck to give to cigna.

43   Bigsby   2012 Dec 17, 3:52pm  

chanakya4773 says

Having a charity or govt run hospital for the poor and needy atleast allows us to control the money we will be shelling out to the free loaders.
These hospitals will be with bare minimum facilities to at least not let people die on streets.

Today , the free loaders have free pass to the private sector hospital emergency rooms and they are creating havoc in the system. the better option is to remove the mandate from private sector to service them in emergency rooms and create a govt run hospital for emergency services.
these will be similar to the services we provide for homeless people.

ofcourse the hospitals will be shitty but that's what you get for free.

The total cost that we will be bearing will be far low because we won't be giving them top of the line emergency services for free at our expense which is what is happening now. instead we will be giving them bare minimum services and we will control how much to spend on it as well.

You are such a compassionate soul. How did you ever become so considerate of your fellow human beings? You talk so much about India that I guess it must be Gandhi's influence.

44   Bigsby   2012 Dec 17, 4:01pm  

chanakya4773 says

Are you f** crazy. you are googling all over the place to get some crappy data. talk to someone who has lived in india and you will know how indian health care works. some useless and incomplete document from web on indian healthcare system is not enough to prove that there in no free market private health care system in india. .Its a fact that most middleclass people in india have access to fully private free market based health care system in india.majority of them are direct cash payments.ofcourse there are some shitty govt run hospitals to service the poor who are completely broke but no middleclass person will dare to go there and nobody does. The Govt does not mandate the private sector to service a person irrespective of their ability to pay.
if a person tries to go to a private hospital and demands to be treated without paying them, they will cut his balls off ;-)

So you espouse having healthcare run by charities (or government, depending on how the mood takes you) if you are poor, and there are a lot of poor in India, and in the same breath say how shitty that healthcare is. Let's just summarize your argument - if you've got the cash, you get the healthcare you oh-so-deserve. If you're poor, you can basically just fuck off and take your chances because, well, you're poor. Like I said, you're a compassionate soul.

45   Bigsby   2012 Dec 17, 4:03pm  

chanakya4773 says

Its a human thing not to let people die. if you don't have that..there is a problem with you. that does not mean you allow people to use that excuse to game the system and create a huge burden. I would any day donate a small sum to help a homeless who is really desperate or help save a life. that does not mean i'll write a blank check to everyone of them ( which is what is happening now).

Thats why charity based hospitals fit the model very well because the free money that people get are based on people's compassion which serves only the really desperate for their desperate needs and thus automatically control costs. we are giving too many very expensive freebies in todays system.

Have you actually taken a look at the WHO's list of the best healthcare systems around the world and their related costs? I think you need to.

46   Bigsby   2012 Dec 17, 4:11pm  

chanakya4773 says

If you are poor and you are asking somebody else to pay for you...you only get what the other person is willing to give you on compassionate grounds . whats so difficult to understand here. anything else would be called extortion. do you like to do extortion ?

Let me guess, you're poor because that's the consequence of your past life and so you only deserve what I deem fit to hand out to you. I suspect that would be nothing in your case. I tell you what, let's go back to the days of poor houses and the like whilst we are at it.

47   Bigsby   2012 Dec 17, 4:14pm  

chanakya4773 says

If a homeless guy comes to you for help ..would you like to have him "demand" money or would you like to give him whatever you thing is right on compassionate grounds ?
i know when i give him few dollars that he will be able to eat only eat very inexpensive not so great restaurant versus a steak house....but thats what i am willing to give away for free. anything wrong with that?

How about having a society that actually tries to prevent homelessness rather than just having people like you thinking they're doing the very best for them by tossing them a couple of dollars when/if the mood ever takes you?

48   Bigsby   2012 Dec 17, 4:19pm  

chanakya4773 says

Bigsby says

Let me guess, you're poor because that's the consequence of your past life and so you only deserve what I deem fit to hand out to you.

well then go earn it. why do you want other people's hard earned money.
do you think they got it for free

Because not everybody is as fortunate as you so obviously seem to be. Personally, I'd much prefer to live in a society that tries to take care of every citizen's medical needs rather than one that is based on your philosophy of 'fuck you, I've got mine.'

49   Bigsby   2012 Dec 17, 4:21pm  

chanakya4773 says

Bigsby says

How about having a society that actually tries to prevent homelessness

The best one known to man today : free market enterprise. If there exists something better, its definitely is not known yet.

Complete and utter bullshit.

50   Bigsby   2012 Dec 17, 4:31pm  

chanakya4773 says

you need to understand something here.
there is only fixed amount of health care resources available in US. if you take something from it and give it away free to somebody. somebody else is not getting it. its called rationing. rationing should be the last resort. The focus should be to grow the pie . in this case, healthcare resources pie. one way to grow the pie is to make every person contribute money to grow the pie. that why you cannot just give freebies.

You need to understand something. The US ranks 38th on the WHO's rankings of health systems whilst spending the highest amount per capita by a long way - $2500 more (according to the OECD) than the next highest spender. This isn't an issue of money or lack thereof. It's an issue of how the country has decided to spend its money on healthcare.

51   Bigsby   2012 Dec 17, 4:33pm  

chanakya4773 says

There is nothing wrong with that concept. the approach is wrong though.
Given the high cost of healthcare, there is this huge outcry that you are venting. but you failed to find out why the costs are so high. before attempting to ration it, we should try to find a better way. the better way is to focus on reducing the cost so that its available to everybody.
rationing will only make all hospitals shitty.

giving govt mandated freebies creates lot a waste because there is lot of abuse since its free. that increases cost for everybody.

Yes, there are better ways. You could simply look at what the highest ranking healthcare systems have done. And guess what, none of them have done what you are arguing for. Amazing I know, but there you go.

52   Bigsby   2012 Dec 17, 4:35pm  

chanakya4773 says

you can read my original post. lets talk once you read that. we all know its
broken but rationing is not going to fix it.

actually rationing of emergency services is already happening. how is that helping you ?

I've already read all your posts. I fundamentally disagree with what you are saying as you should quite clearly be able to understand. And it's laughable that you are complaining about rationing because your argument seems to be to leave the poorest in society to their chances. Charity hospitals for very basic care if you are lucky, seemingly.

53   Bigsby   2012 Dec 17, 4:45pm  

chanakya4773 says

there is bigger problem here that just following what others have done.
even though other countries can brag all they want about their system, US medical field is the most advanced and is the innovation engine of the entire world. other people piggy back on our innovation.
Once you kill this system here , there will be bigger repercussions than you can imagine. sometimes the intentions are good but the results are not.The last thing you want is stagnation in medical field innovation and lose the opportunity to save thousands of lives across the globe. most countries have chosen the non-free market approach but it does not matter since US is the innovation engine anyway.

there should be every effort to keep most part of the health care system here money making industry so that people keep innovating.
once you take away the incentive to make money , innovation will die for sure.

Kill what? There's plenty of major medical innovation that comes from Europe, for example. Having comprehensive healthcare coverage isn't the death knell for medical advancement, though your plans for medical healthcare might well be the death knell for any semblance of a civilized society.

54   Bigsby   2012 Dec 17, 5:36pm  

chanakya4773 says

you didn't answer on how to prevent homelessness for good...any ideas ?

It's obviously a highly complex issue, but an entirely free market has absolutely no interest in dealing with that kind of problem, and if you don't see that, then there's little point in discussing anything with you.

55   Bigsby   2012 Dec 17, 5:42pm  

chanakya4773 says

I would also be interested to know why somebody ( who is already fully burdened) should be paying for your emergency room visits?
for every free emergency room visit that happens today , there is probably some already broke family paying for it.

Then perhaps you should try and understand a system such as the one the French have. Most people aren't that desperate to pick up a gun and kill a few taliban, but they understand the need for some of their dollars to go towards defense expenditure. Why can't their dollars also go towards universal healthcare? You do understand that most people wouldn't be making the choice to pay twice, and based on current US per capita expenditure, it would be highly likely that LESS of an individual's money would be going towards funding their healthcare than is the case now whilst simultaneously enabling universal coverage. That's a win-win in my book, but apparently it means something else to you.

« First        Comments 16 - 55 of 91       Last »     Search these comments

Please register to comment:

api   best comments   contact   latest images   memes   one year ago   random   suggestions