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

[framer]

- 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.


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I never suggested this, I just made the offhand statement that just providing a copay at the emergency room for everyone would help segregate care to the most effective venue. I'm not sure we actually disagree on this.

 

[One Brow]

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.

Government bureaucrats don't set the prices under the ACA, except for Medicare/Medicaid/etc. That's done by private insurers.

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.

You assume wrongly. The more personal something is, the worse that people are at objectively evaluating it. Very few things are more personal than healthcare decisions.

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.

The VA scandal was an issue with underfunding following a massive increase in the number of veterans and the percentage of battle survivors.

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

A video from a fellow worshiper of the god called "free market" is not evidence.

One reason for price variations is that insurance companies cover plans, not individual procedures. Company X may offer a very low reimbursement for procedure A and a relatively high reimbursement for B, while company Y might pay more for A and less for B. Of course, when some unlearned person comes along and looks at prices, they notice the variation in the cost of X or the cost of Y, without understanding how all the different costs come together in a coverage plan.

 

[framer]

Government bureaucrats don't set the prices under the ACA, except for Medicare/Medicaid/etc. That's done by private insurers.



You assume wrongly. The more personal something is, the worse that people are at objectively evaluating it. Very few things are more personal than healthcare decisions.



The VA scandal was an issue with underfunding following a massive increase in the number of veterans and the percentage of battle survivors.



A video from a fellow worshiper of the god called "free market" is not evidence.

One reason for price variations is that insurance companies cover plans, not individual procedures. Company X may offer a very low reimbursement for procedure A and a relatively high reimbursement for B, while company Y might pay more for A and less for B. Of course, when some unlearned person comes along and looks at prices, they notice the variation in the cost of X or the cost of Y, without understanding how all the different costs come together in a coverage plan.

Why do you fear freedom?
1. Bureaucrats DO determine the healthcare costs due to mandates passed on to the insurance companies. These mandates are accepted happily by the insurance companies because they know if they go into the red, they will be bailed out by the federal government. There is no reason that a 65 year old man should have to pay for maternity coverage. Because of this, the line between the federally subsidized insurance companies and the government is very thin.
2. Again, LET PEOPLE DECIDE FOR THEMSELVES. I reject your unscientific assertion that the government knows best in these areas. More government healthcare will pry people away from their trusted physicians, who are the best qualifies to help people plan their medical future. If you want Ezekiel Emmanuel to make your healthcare decisions, more power to you. Let the rest of us go to our family doctors.
3. Bull****. The VA had just received massive increases in funding. Politifact says the you are full of crap here. The failure was in leadership and bureaucrat unaccountability. It killed verterans, but you are willing to subject everyone to the same type of "healthcare."
4. Dude cites several studies. You made the statement there was "no proof." Clearly there is, but since it isn't published in the Daily Kos, it doesn't exist. . .

 

[One Brow]

Why do you fear freedom?
1. Bureaucrats DO determine the healthcare costs due to mandates passed on to the insurance companies. These mandates are accepted happily by the insurance companies because they know if they go into the red, they will be bailed out by the federal government. There is no reason that a 65 year old man should have to pay for maternity coverage. Because of this, the line between the federally subsidized insurance companies and the government is very thin.
2. Again, LET PEOPLE DECIDE FOR THEMSELVES. I reject your unscientific assertion that the government knows best in these areas. More government healthcare will pry people away from their trusted physicians, who are the best qualifies to help people plan their medical future. If you want Ezekiel Emmanuel to make your healthcare decisions, more power to you. Let the rest of us go to our family doctors.
3. Bull****. The VA had just received massive increases in funding. Politifact says the you are full of crap here. The failure was in leadership and bureaucrat unaccountability. It killed verterans, but you are willing to subject everyone to the same type of "healthcare."
4. Dude cites several studies. You made the statement there was "no proof." Clearly there is, but since it isn't published in the Daily Kos, it doesn't exist. . .

1. Mandating coverage is not mandating a price. Charging 64-year-old men the same as 25-year-old women is, despite the maternity coverage, more of a subsidy for the men.
2. I didn't say anything abut the government knowing best. If you want to go to your family doctor, choose a healthcare plan that they use. You do have that choice.
3. Do you have a link to that article, please? Meanwhile, massive increases in funding sere, in fact, overwhelmed by massive increases in the number of veterans and the seriousness of the care they required. The more people we save off the battlefield, the more care we need to offer them.
4. Since you missed it last time, I'll say this more clearly: I think the studies were probably correct. The results he mentioned would be exactly what I would expect. However, given the nature of healthcare plans, the speaker's presentation of the plans was misleading and his subsequent advice misguided.

 

[Deleted member 848]

Why do you fear freedom?

Again, LET PEOPLE DECIDE FOR THEMSELVES. I reject your unscientific assertion that the government knows best in these areas.

l.o.l

More government healthcare will pry people away from their trusted physicians, who are the best qualifies to help people plan their medical future. If you want Ezekiel Emmanuel to make your healthcare decisions, more power to you.

Let the rest of us go to our family doctors.

your use of 'government healthcare' is incredibly ambiguous. It could be referring to a single-party system, a multi-partysystem regulated by the government, the ACA, and basically every health-care system currently existing in this world.

It's really quite sad that you seem to equate state-involvement with restricting people from making personal choices.

People in Japan don't deal with gatekeepers-- EVER. You want to see a specialist? Walk up to his office. Wan't to switch specialists? No one is stopping you. You want an MRI? Not a better place in the world to get one, both in terms of price AND wait-time. Wait, does this come at a cost? Nope. Wait, is this costing the state of Japan thousands of dollars? Well, they're spending probably around 10% of their GDP on healthcare, in comparison to Murikah's 17-18%.

 

[VINYLONE]

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.

Yes, prices do change in all sorts of ways. But in your pizza example, that's a discount given with a coupon, not a price change tied to form of payment. I am always willing to adjust my position on things, so if you can send me some sort of article that talks about price discovery in regards to healthcare, I'd be more than willing to read it. Procedure cost, negotiated price are not, if at all, easyily obtainable. If they were, there would be a price list that anyone can look at regardless of being insured or not. But of course we all know there isn't because prices change depending on form of payment, meaning, whether you are paying with insurance or out of pocket.

Once price discovery is offered prices would instantly drop because that's the way a market works. Those caught in emergencies would benefit from price discovery regardless of whether they were looking for the best price or not.

Im not sure what you mean with your last sentence. It almost sounds like you're an advocate for the current system and health insurance companies.

 

[One Brow]

Yes, prices do change in all sorts of ways. But in your pizza example, that's a discount given with a coupon, not a price change tied to form of payment. I am always willing to adjust my position on things, so if you can send me some sort of article that talks about price discovery in regards to healthcare, I'd be more than willing to read it. Procedure cost, negotiated price are not, if at all, easyily obtainable. If they were, there would be a price list that anyone can look at regardless of being insured or not. But of course we all know there isn't because prices change depending on form of payment, meaning, whether you are paying with insurance or out of pocket.

Once price discovery is offered prices would instantly drop because that's the way a market works. Those caught in emergencies would benefit from price discovery regardless of whether they were looking for the best price or not.

Im not sure what you mean with your last sentence. It almost sounds like you're an advocate for the current system and health insurance companies.

I'm not sure what you mean by "form of payment" here. It doesn't seem to be a 'cash vs. credit card' thing. 'You mean, like how a local restaurant will often give an automatic 5-10% discount on deliveries to a large employer just down the road, but not to the people who live in the housing complex a half-block closer?

Here's an NPR article on the subject:
https://www.npr.org/blogs/health/20...h-how-negotiated-deals-hide-health-cares-cost

Every hospital has its own master list of charges for different services. Those charges are different from hospital to hospital.

But insurance companies don't pay those listed charges. The listed charges are almost fiction. Instead, each insurer negotiates for lower prices with each hospital and doctor on every plan. The negotiated prices even can vary within an insurance company depending on which plan a patient has.

All of this means there are about as many price tags for that hypertension checkup as there are insurers and providers.

Individuals can also negotiate prices with hospitals, but again, when their health is declining, are often not inclined to be strong negotiators. However, you're not going to get the best price offered to any particular insurance company, for example, because insurance companies negotiate for packages of care (that is, they simultaneously set rates for the colonoscopy, chemotherapy, heart-valve implants, etc.) and offer hundreds/thousands of customers. The market in health insurance is not like the market for TVs, and never will be.

I think the current system can be improved. However, last I heard, the country most satisfied with its health care system was Germany, and the German model relies on private companies to compete for customers and control costs.