Jazzfanz: how would YOU rebuild America's health-care system?

[framer]

Removing the free riders to only certain hospitals does not change their free-riding, it just reduces the amount of care they can receive.

Prices change in all kinds of ways. How much a pizza joint charges will depend on whether and which coupons you have. The price you pay at an auto dealership depends on your industry knowledge, research ability, and haggling ability. You can both find out how much a medical procedure costs, and negotiate the price, if you are so inclined. However, most people are not in a frame of mind to negotiate when it comes to serious medical procedures.

No entity is more effective at lowering costs than a health insurance company that can offer the potential for thousands of local customers.

Making free riders obtain the care they need from the proper venue would save a lot of money. Making people go to a clinic rather than an emergency room to treat a slight headache would be a good start. Hell this cold be fixed in most cases by charging a $30 copay no matter what for people using the emergency room.

People are ALWAYS of a mind to negotiate for better prices if it effects THEIR bottom line. Drive around at midnight the morning of Black Friday and tell me people won't go out of their way for a deal. Now imagine that doing a little legwork could save THOUSANDS of dollars. If money were coming out of YOUR savings account, there would be websites popping up everywhere with price comparisons just like with just about every other product imaginable. To say people wouldn't be able to quickly determine where they could get a better deal just doesn't hold water.

No entity is more effective at removing you from your preferred care provider than a health insurance company. . .

 

[Gameface]

I wish Obama was more clutch.

 

[One Brow]

Did you just make an argument supporting the health insurance industry?

Has the ACA moved the left that far to the right on healthcare?

Not just earlier in this thread, but for at least a year now whenever it has come up, I've supported publicly paid premiums through private health insurers, something like the German model.

I've always seen myself as a pragmatist. I'm for what works, and the German model seems to work very well.

 

[Deleted member 848]

Not just earlier in this thread, but for at least a year now whenever it has come up, I've supported publicly paid premiums through private health insurers, something like the German model.

I've always seen myself as a pragmatist. I'm for what works, and the German model seems to work very well.

Japan has a good model too, pending they spend a liiiittle more on healthcare. Which they have been instating. Can't have all of those hospitals going bankrupt.

 

[One Brow]

The root of all of this is that treating Pneumonia costs thousands of dollars. It shouldn't. Historically it didn't.

Historically, people died from not being treated, which is the risk bigb is facing. While no human life can be boiled down to dollars and cents only, how much will the government make in input from his wife (even if she never works outside the home, her contributions inside support the economy regardless) over her lifetime? Even on just a financial level, much less a human level, it makes sense to spend the couple of hundred (not thousands, as long as you can avoid being hospitalized, which early treatment makes more likely) for her treatment.

 

[Deleted member 848]

Making free riders obtain the care they need from the proper venue would save a lot of money.

Yes, but it's also unfeasible.

Making people go to a clinic rather than an emergency room to treat a slight headache would be a good start. Hell this cold be fixed in most cases by charging a $30 copay no matter what for people using the emergency room.

A $30 copay would be much better than what some Americans end up paying. Germany has copayments for G.P. visits IIRC

People are ALWAYS of a mind to negotiate for better prices if it effects THEIR bottom line. Drive around at midnight the morning of Black Friday and tell me people won't go out of their way for a deal. Now imagine that doing a little legwork could save THOUSANDS of dollars.

Wrong. Health isn't a discrete commodity, like a 32" Samsung LED TV-- where the exact same item drops in price across several retailers (and at different times of the year), so you can go bargain-hunting for it with ease.

Relating health to the drop in price of a commodity is rather narrow-minded, in my opinion. No headache is the same. Not everyone is a ****ing doctor-- how are they going to know if they have a migraine, had a stroke, have meningitis, have brain cancer? With something like a stroke, seeking emergency room care within three hours can be absolutely life-changing. Instead, your 'idea' would create a propensity for the uneducated to self-medicate, and 'surf for prices, or the right hospital'. This would be a ****ing nightmare for people suffering strokes. You need to separate yourself from the notion that emergency-care is primarily involved with slowly-onsetting illnesses. Your plan puts way too much of an emphasis on lowering cost, and would guaranteed result in probably the first generational life-expectancy reversal in U.S history.

If money were coming out of YOUR savings account, there would be websites popping up everywhere with price comparisons just like with just about every other product imaginable. To say people wouldn't be able to quickly determine where they could get a better deal just doesn't hold water.

No entity is more effective at removing you from your preferred care provider than a health insurance company. . .

[/QUOTE]

Again, see above. Health is not discrete.

 

[One Brow]

Making free riders obtain the care they need from the proper venue would save a lot of money. Making people go to a clinic rather than an emergency room to treat a slight headache would be a good start. Hell this cold be fixed in most cases by charging a $30 copay no matter what for people using the emergency room.

People are ALWAYS of a mind to negotiate for better prices if it effects THEIR bottom line.

I just can't be as callous as you are about people dying because they didn't seek treatment when they should have.

When your leg is broken, you are not in a frame of mind to shop around for the cheapest X-rays.

How much does a vaccination cost? Under your medical savings plan, how much should a family of four be willing to pay in a year to have their kids vaccinated?

 

[framer]

I just can't be as callous as you are about people dying because they didn't seek treatment when they should have.

When your leg is broken, you are not in a frame of mind to shop around for the cheapest X-rays.

How much does a vaccination cost? Under your medical savings plan, how much should a family of four be willing to pay in a year to have their kids vaccinated?

I'm not talking about broken legs or cancer. I'm talking about a headache or other non-life threatening issues. My brother is a paramedic in Vegas and tells me that at least half of his calls are to people that could treat their issue at the "pharmacy" section of the Circle K. Not only is this expensive it is tying up people who are needed for real emergencies. If there is a $40 copay at the emergency room and nothing at the clinic, they will only go to the emergency room if it is an actual emergency.

People seem to do OK at getting to "provider" hospitals during an emergency, they would probably have a good idea of a hospitals affordability before the accident happened in many cases. Again, the end goal is to bring down the cost of medicine for everybody across the board while doing our level best to not sacrifice choice or quality.

A flu shot costs $25 right now with no insurance at the market rate. You can get them for $10 or $15 if you are actively looking for a "sale." If the government was kicking in $100 to $200 dollars a month into your Savings account, the vaccinations wouldn't be much of an issue.

 

[Harambe]

Single Payer, government. Faults? Yes. Perfect? No. Can we as a country afford it? You're darned tootin.

 

[One Brow]

I'm not talking about broken legs or cancer. I'm talking about a headache or other non-life threatening issues. My brother is a paramedic in Vegas and tells me that at least half of his calls are to people that could treat their issue at the "pharmacy" section of the Circle K. Not only is this expensive it is tying up people who are needed for real emergencies. If there is a $40 copay at the emergency room and nothing at the clinic, they will only go to the emergency room if it is an actual emergency.

People seem to do OK at getting to "provider" hospitals during an emergency, they would probably have a good idea of a hospitals affordability before the accident happened in many cases. Again, the end goal is to bring down the cost of medicine for everybody across the board while doing our level best to not sacrifice choice or quality.

A flu shot costs $25 right now with no insurance at the market rate. You can get them for $10 or $15 if you are actively looking for a "sale." If the government was kicking in $100 to $200 dollars a month into your Savings account, the vaccinations wouldn't be much of an issue.

How is a medical civilian supposed to know when a headache is truly non-life-threatening, when even your paramedic brother needs to take these cases to the hospital, just in case?

Yes, if you know which hospital is in network beforehand, you don't need to shop around.

How much for measles/mumps/rubella? Meningitis? Shingles? Oral polio?

Her's some help:
https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/

That $25 cost you mentioned is subsidized, BTW.

 

[framer]

How is a medical civilian supposed to know when a headache is truly non-life-threatening, when even your paramedic brother needs to take these cases to the hospital, just in case?

Yes, if you know which hospital is in network beforehand, you don't need to shop around.

How much for measles/mumps/rubella? Meningitis? Shingles? Oral polio?

Her's some help:
https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/

That $25 cost you mentioned is subsidized, BTW.

I'm going to say that unless there is an object protruding from your head, you are probably OK not going to the ER for a headache. Stop being obtuse.

If your car breaks down do you throw your hands up in terror because there is no way to know where to go? Generally you have a relationship with a business or mechanic. It USED to be that way for medicine too. If Medical Care becomes more of a service again, that type of relationship can return.

Nothing says government or foundations can't have an interest in subsidizing vaccinations, even with a more market friendly healthcare system.

 

[♪alt13]

Okay, so I'm experiencing the frustrations of all this right now. Here are some of the problems I'm seeing:
1. Cost of insurance ins't proportional to expenses. I work for my dad. It's just the two of us as full time employees. My dad covers himself and my mom. My mom has had some health issues, so naturally her insurance is expensive. But because I'm their employee, my insurance is linked to theirs, meaning the price is outrageous. It's over $400 a month JUST FOR ME. and that's for a high deductible, low coverage policy without vision or dental. And that cost goes up every year. I'm an overall healthy guy who hasn't been to the doctor (other than one physical and one x-ray) in well over a decade. Seriously, no health issues at all. The insurance company is making a fortune off me. Why the hell does my insurance cost so much? I look at this situation and I think to myself "why does the cost continue to go up for something that isn't being used?"
2. The rules regarding signing up are ridiculous. Based on my income and how many kids we have, my wife qualified for Medicaid while she was pregnant with our last kid. That only lasted through the pregnancy and for two months after the birth. I'm great with that. Now she qualifies for government help with our premiums, but she has to be uninsured for three months before that can go into effect. And she has to go with literally the worst plan offered. So she isn't insured until December 1. Now my uninsured wife is dealing with what we are 99% sure is pneumonia. Do we go to the doctor (Insta-Care or ER) and have to pay thousands and thousands of dollars? Or do we try to treat it as best we can at home and hope she gets over it? Not exactly the type of decisions humans should be forced to make.
3. The income levels between qualifying for government help (Medicaid, CHIP) don't translate into real life. I never understood how people let themselves stay on government assistance without doing anything about it. Now, dealing with it, I totally get it. In order to make a change and get off assistance, people almost need to get a second full time job to make up for the money they'll have to start paying for insurance and food. It's way easier for most people to just stay where they are and take the assistance.
How to fix this? I haven't the foggiest. I fear that without the government stepping in and mandating a maximum cost or mandating certain "benefits" for people who don't have big yearly medical expenses, nothing will change. If car insurance companies can give discounts to those who don't make claims or who practice good driving, why can't health insurance companies do the same? It's pretty simple: $$$$.

I completely agree with this. My wife has more than one employee that she manages that would see their housing increase, their food stamps decrease, and their medical coverage evaporate if they were to work more hours. IIRC the people that are in this predicament tend to limit their hours to around 25 a week anything beyond that would actually reduce their standard of living. It is my view that they should not be penalized for doing better for themselves rather that they should be incentivized to do so.

I think that all these programs need to refocus on trying to lift the working poor out of poverty rather than just alleviate some of their hardships . I think that the core problem is that benefits seem to decline too rapidly and that each program is basically separate. It doesn't look so bad for someone to lose a percentage of their food stamps when you look at the single program, but when you consider that they are also getting decreased benefits in other areas you realize that the reductions tend to add up quickly.

I would end all the piecemeal programs and start again with a more holistic anti-poverty program. I would ensure that each step up a person made was really a step up rather than just even steven.

 

[Deleted member 848]

I'm not talking about broken legs or cancer. I'm talking about a headache or other non-life threatening issues. My brother is a paramedic in Vegas and tells me that at least half of his calls are to people that could treat their issue at the "pharmacy" section of the Circle K. Not only is this expensive it is tying up people who are needed for real emergencies. If there is a $40 copay at the emergency room and nothing at the clinic, they will only go to the emergency room if it is an actual emergency.

Mild display of symptoms can be emergencies. You seem to be missing this. Completely.

Will be funny seeing the heads of those who support this theory spin, when there's a massive rise in strokes with much more serious debilitations, creating a significant dent in the medical budget in order to provide the proper treatment for them.

Your solution of some people abusing the ER is to essentially go to the complete other end of the spectrum. That's simply non-pragmatic.

People seem to do OK at getting to "provider" hospitals during an emergency, they would probably have a good idea of a hospitals affordability before the accident happened in many cases. Again, the end goal is to bring down the cost of medicine for everybody across the board while doing our level best to not sacrifice choice or quality.

A flu shot costs $25 right now with no insurance at the market rate. You can get them for $10 or $15 if you are actively looking for a "sale." If the government was kicking in $100 to $200 dollars a month into your Savings account, the vaccinations wouldn't be much of an issue.

flu shots aren't the only type of vaccination. It's free for y'all probably, but Gardasil up here costs around $150.

 

[Deleted member 848]

I'm going to say that unless there is an object protruding from your head, you are probably OK not going to the ER for a headache. Stop being obtuse.

If your car breaks down do you throw your hands up in terror because there is no way to know where to go? Generally you have a relationship with a business or mechanic. It USED to be that way for medicine too. If Medical Care becomes more of a service again, that type of relationship can return.

Nothing says government or foundations can't have an interest in subsidizing vaccinations, even with a more market friendly healthcare system.

1) irony of calling OneBrow obtuse when that same stanza has an obtuse remark.
2) Again, you continue to relate the human body to discrete, non-biological things. Apples and oranges.

 

[Harambe]

Mild display of symptoms can be emergencies. You seem to be missing this. Completely.

Will be funny seeing the heads of those who support this theory spin, when there's a massive rise in strokes with much more serious debilitations, creating a significant dent in the medical budget in order to provide the proper treatment for them.

Your solution of some people abusing the ER is to essentially go to the complete other end of the spectrum. That's simply non-pragmatic.

I too, lulled when I read the previously quoted statement. But I lulled so hard I didn't type up a 7 page response.

Thanks for dropping that down to four lines.

 

[framer]

Mild display of symptoms can be emergencies. You seem to be missing this. Completely.

Will be funny seeing the heads of those who support this theory spin, when there's a massive rise in strokes with much more serious debilitations, creating a significant dent in the medical budget in order to provide the proper treatment for them.

Your solution of some people abusing the ER is to essentially go to the complete other end of the spectrum. That's simply non-pragmatic.



flu shots aren't the only type of vaccination. It's free for y'all probably, but Gardasil up here costs around $150.

What medical care are you getting where every headache is cause for a raft of stroke and cancer testing and treatments? Because that ain't happening now, and it CERTAINLY isn't going to start happening with what is evolving in Obamacare. Right now, unless you have compounding symptoms, you get your $45 aspirin, sit around for 4 hours, then get sent home, which could also happen in a clinic for much cheaper without the kid with the broken leg waiting in line behind you. Had a broken leg lately? My kid had to wait 3 days before the care could be freed up enough for somebody to set the fracture. If they have the symptoms of strep, I can get them in and out of the clinic in about 45 minutes. People are clogging up the system by being stupid. If it costs them $30 each time, eventually they will learn.

A market based system would lower costs across the board. That $150 shot would be maybe $100, and if you are lower income, that money would come out of your subsidized savings account. So what's your beef?

 

[One Brow]

People are clogging up the system by being stupid. If it costs them $30 each time, eventually they will learn.

My copay for an emergency room is $50, while it's $35 for an urgent care and $0 if I go to a clinic we own. The incentive you speak of already exists.

A market based system would lower costs across the board. That $150 shot would be maybe $100, and if you are lower income, that money would come out of your subsidized savings account. So what's your beef?

There is no proof for your statement.

 

[Deleted member 848]

What medical care are you getting where every headache is cause for a raft of stroke and cancer testing and treatments? Because that ain't happening now, and it CERTAINLY isn't going to start happening with what is evolving in Obamacare. Right now, unless you have compounding symptoms, you get your $45 aspirin, sit around for 4 hours, then get sent home, which could also happen in a clinic for much cheaper without the kid with the broken leg waiting in line behind you. Had a broken leg lately? My kid had to wait 3 days before the care could be freed up enough for somebody to set the fracture. If they have the symptoms of strep, I can get them in and out of the clinic in about 45 minutes. People are clogging up the system by being stupid. If it costs them $30 each time, eventually they will learn.

A market based system would lower costs across the board. That $150 shot would be maybe $100, and if you are lower income, that money would come out of your subsidized savings account. So what's your beef?

- if you scroll up, you'll see that I never, ever mentioned being against copayments.
- id rather have a child wait 2 extra days to set a fracture than have leave an entire population susceptible to stroke from a state-emphasis on self-medication.


Sent from my iPhone using Tapatalk

 

[framer]

Yes, but it's also unfeasible.



A $30 copay would be much better than what some Americans end up paying. Germany has copayments for G.P. visits IIRC



Wrong. Health isn't a discrete commodity, like a 32" Samsung LED TV-- where the exact same item drops in price across several retailers (and at different times of the year), so you can go bargain-hunting for it with ease.

Relating health to the drop in price of a commodity is rather narrow-minded, in my opinion. No headache is the same. Not everyone is a ****ing doctor-- how are they going to know if they have a migraine, had a stroke, have meningitis, have brain cancer? With something like a stroke, seeking emergency room care within three hours can be absolutely life-changing. Instead, your 'idea' would create a propensity for the uneducated to self-medicate, and 'surf for prices, or the right hospital'. This would be a ****ing nightmare for people suffering strokes. You need to separate yourself from the notion that emergency-care is primarily involved with slowly-onsetting illnesses. Your plan puts way too much of an emphasis on lowering cost, and would guaranteed result in probably the first generational life-expectancy reversal in U.S history.

Again, see above. Health is not discrete.[/QUOTE]

Obamacare will put the emphasis on LOWERING COST. The difference with my plan is that YOU get to chose where the cost is lowered rather than a government bureaucrat. You assume that people are unable to look after their own healthcare. I assume that people are the BEST people to look after their own healthcare, and make rational choices with the financing of the healthcare. I also assume that people are better off choosing their own provider rather than being assigned. Sometimes somebody might make a bad choice, but that is far better than having the bad choice made for them like we saw with the VA scandal.

 

[framer]

My copay for an emergency room is $50, while it's $35 for an urgent care and $0 if I go to a clinic we own. The incentive you speak of already exists.



There is no proof for your statement.

https://www.youtube.com/watch?v=W6mtJmWVIds