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Why free-market healthcare doesn't work...

augcaesarustus
Posts: 368
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10/18/2016 5:01:32 AM
Posted: 1 month ago
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.
Greyparrot
Posts: 14,282
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10/18/2016 5:27:51 AM
Posted: 1 month ago
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

Umm..you won't be able to under any system. Scarcity will always exist, and so will rationing under any system.

However, allowing the rich to pay for expensive plans and the poor to pay for basic plans allows the actual funding to make quality healthcare for all. Otherwise there will just be global free market alternatives when mandated rationing occurs, as the rich take their healthcare dollars and spend it on, say, free market Caribbean doctors. That's less actual local healthcare money to support the healthcare system, and you know the government will never actually tax the rich, no matter how many empty campaign promises.
augcaesarustus
Posts: 368
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10/18/2016 5:34:37 AM
Posted: 1 month ago
At 10/18/2016 5:27:51 AM, Greyparrot wrote:
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

Umm..you won't be able to under any system. Scarcity will always exist, and so will rationing under any system.

However, allowing the rich to pay for expensive plans and the poor to pay for basic plans allows the actual funding to make quality healthcare for all. Otherwise there will just be global free market alternatives when mandated rationing occurs, as the rich take their healthcare dollars and spend it on, say, free market Caribbean doctors. That's less actual local healthcare money to support the healthcare system, and you know the government will never actually tax the rich, no matter how many empty campaign promises.

Single-payer healthcare systems offer such a system: look at France.
augcaesarustus
Posts: 368
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10/18/2016 5:44:20 AM
Posted: 1 month ago
This is a video from a YouTube Channel called 'Healthcare Triage'. It's a good Channel which compares healthcare systems of different countries (among other things). The link below is about France's healthcare system.

https://www.youtube.com...
Stymie13
Posts: 2,162
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10/18/2016 11:24:18 AM
Posted: 1 month ago
These threads are ridiculous. You make an assertion. Now spell out how it's to be implemented? And no, France does x... isn't an answer.
TBR
Posts: 9,991
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10/18/2016 12:30:12 PM
Posted: 1 month ago
At 10/18/2016 11:24:18 AM, Stymie13 wrote:
These threads are ridiculous. You make an assertion. Now spell out how it's to be implemented? And no, France does x... isn't an answer.

Well... It's a reasonable question. How can a free market provide a service like this. The answer is, it can't. We either have to change the requirements of the service or accept that it cannot be provided to all. If on the other hand we insist it be a service for all, and fit the requirements, it needs to be outside the free market.
Stymie13
Posts: 2,162
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10/18/2016 12:45:53 PM
Posted: 1 month ago
At 10/18/2016 12:30:12 PM, TBR wrote:
At 10/18/2016 11:24:18 AM, Stymie13 wrote:
These threads are ridiculous. You make an assertion. Now spell out how it's to be implemented? And no, France does x... isn't an answer.

Well... It's a reasonable question. How can a free market provide a service like this. The answer is, it can't. We either have to change the requirements of the service or accept that it cannot be provided to all. If on the other hand we insist it be a service for all, and fit the requirements, it needs to be outside the free market.

Therein lies the issue. It is easy to make an assertion. Implementing it is a whole other animal. So few have any working knowledge of all the different facets that healthcare is intertwined into the economy, the 50 year evolution of the current system first framed up by the Blues back in the late 50's, and the change not in the industry but consumer use makes it a fantastical claim.

I have asked many advocates to outline a framework. The best they get to is Medicare for all. Well Medicare started as catastrophic coverage then ...

* encompassed Part B
* Medicare advantage for cost containment (and providers beginning to not be deemed)
* Gap plans (medigap)
* Part D prescription drug plans...

Single payer in that aspect operated at a 100 billion dollar loss +- a bill here or there. And that doesn't even take into account the MA plans. People knock Himana and the others, but why did MA plans arise? Simple: DHHS begging privates to take members off traditional Medicare, and incentivizing those members, because the FI's and Part B's (now consolidated as MACs) could not administer. That all occurred in the 80s (not part d) and has only accelerated.
Stymie13
Posts: 2,162
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10/18/2016 1:00:59 PM
Posted: 1 month ago
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).
kevin24018
Posts: 1,843
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10/18/2016 1:33:20 PM
Posted: 1 month ago
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...
v3nesl
Posts: 4,489
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10/18/2016 1:42:29 PM
Posted: 1 month ago
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
.... So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

How about healthcare that fixes what's wrong with you, would that be part of your equation?
This space for rent.
Stymie13
Posts: 2,162
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10/18/2016 1:47:28 PM
Posted: 1 month ago
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?

But even that doesn't account for BUILDING and IMPLEMENTING single payer here.

It's estimated there are between 5 and 7 million contracts of varying sorts tied to the healthcare industry (I surmise higher). There are 3.5 million registered NPI's and each one has contracts with;

Payers
Medicaid
Clearing houses
Pms systems
Coding professionals
Lawyers
Accountants
Other practitioners
Ambulance services
Other BA (biz assoc) that do things transactionalky

You get the point. Are all those contracts going to be deemed null and void from legislation? That is just 1 other aspect (not including coding, reimbursement, benefits covered, administration, governing body, etc..., etc..., etc...)

Keep in mind: it's a 1/3 of the economy.
v3nesl
Posts: 4,489
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10/18/2016 1:48:10 PM
Posted: 1 month ago
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

And a free market is de-regulated. In a free market you choose the level of quality you want. I know, everybody freaks out at the mere mention of the idea in a medical context, but I'm just saying, that's what a free market is. Healthcare has been a government protected monopoly for a long long time, and exhibits all the bad behaviors of a monopoly.

And the quality of healthcare has been going down rapidly in the US anyway. More and more healthcare is provided by Physician's Assistants (PA) and not doctors for instance. We just have little choice in this lowering of quality. And this quality problem will only accelerate if Hillary gets in.
This space for rent.
v3nesl
Posts: 4,489
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10/18/2016 1:50:01 PM
Posted: 1 month ago
At 10/18/2016 1:47:28 PM, Stymie13 wrote:
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?


Yes, excellent point.
This space for rent.
Stymie13
Posts: 2,162
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10/18/2016 1:51:01 PM
Posted: 1 month ago
At 10/18/2016 1:48:10 PM, v3nesl wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

And a free market is de-regulated. In a free market you choose the level of quality you want. I know, everybody freaks out at the mere mention of the idea in a medical context, but I'm just saying, that's what a free market is. Healthcare has been a government protected monopoly for a long long time, and exhibits all the bad behaviors of a monopoly.

And the quality of healthcare has been going down rapidly in the US anyway. More and more healthcare is provided by Physician's Assistants (PA) and not doctors for instance. We just have little choice in this lowering of quality. And this quality problem will only accelerate if Hillary gets in.

Actually more nurse practitioners than PA's but your point isn't lost. It is estimated 30-35% of pcps are currently from those 2 fields and it's expected to climb past 50% by 2025.
Robkwoods
Posts: 570
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10/18/2016 1:53:02 PM
Posted: 1 month ago
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
This doesn't occur under the current system. This is not a realistic goal under either system. You can not force individuals to be at your beckoning call, that is slavery.

ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
There are no restrictions under a laissez faire system, other than they may not have time in their schedule. The same thing occurs now.

iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
You are referring to out of pocket cost. Someone is still paying for it. I don't want to pay for your weekly psych visits. You pay for that.

iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.
So people are no longer responsible for self harm. Awesome.


This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

The fact is that the easiest path out of the ACA is the single-payer. I actually would love for this to happen. It will fail spectacularly (see Vermont). We will then move back to Laissez Faire and have a recent example of why government isn't good for anything.

The harder path is a movement to Laissez Faire. The weave is tightly wound. The starting point is very important. There is a doctor shortage, obesity problem, Medicaid problem, Medicare problem, now an private Insurance company shortage, mental health problem.

Step 1: Abolish the FDA and AMA. This will remove barriers to entry for Doctors, Medical equipment, and Medicine.

Step 2: Medicaid and Medicare must be replaced by HSA. How will people pay for their medical care? Step 1 in theory should create a competitive market will competitive prices.

That's it.

Obesity problem will fix itself. Private Insurance will come back in response to the need for it. Private insurance was originally created for traumatic/emergent care not your annual dental check up. Mental health problems can only be handled by bringing back the nuclear family.
kevin24018
Posts: 1,843
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10/18/2016 1:54:22 PM
Posted: 1 month ago
At 10/18/2016 1:47:28 PM, Stymie13 wrote:
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?

But even that doesn't account for BUILDING and IMPLEMENTING single payer here.

It's estimated there are between 5 and 7 million contracts of varying sorts tied to the healthcare industry (I surmise higher). There are 3.5 million registered NPI's and each one has contracts with;

Payers
Medicaid
Clearing houses
Pms systems
Coding professionals
Lawyers
Accountants
Other practitioners
Ambulance services
Other BA (biz assoc) that do things transactionalky

You get the point. Are all those contracts going to be deemed null and void from legislation? That is just 1 other aspect (not including coding, reimbursement, benefits covered, administration, governing body, etc..., etc..., etc...)

Keep in mind: it's a 1/3 of the economy.

it's a mess for sure, and getting worse, rather than reducing waste and making what we have more efficient with the contracts, lawsuits and the usual government waste we just add more layers and barriers so the ignorant masses will stay that way. I've read and seen plenty about Canada's system, if you have lots of money you are fine, if you don't the wait times are unbelievable. then as you mentioned compare the tax rates etc How quickly people forget what kind of health plans our elected officials get and how they didn't want to give that up for obama care.
Stymie13
Posts: 2,162
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10/18/2016 2:00:17 PM
Posted: 1 month ago
At 10/18/2016 1:54:22 PM, kevin24018 wrote:
At 10/18/2016 1:47:28 PM, Stymie13 wrote:
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?

But even that doesn't account for BUILDING and IMPLEMENTING single payer here.

It's estimated there are between 5 and 7 million contracts of varying sorts tied to the healthcare industry (I surmise higher). There are 3.5 million registered NPI's and each one has contracts with;

Payers
Medicaid
Clearing houses
Pms systems
Coding professionals
Lawyers
Accountants
Other practitioners
Ambulance services
Other BA (biz assoc) that do things transactionalky

You get the point. Are all those contracts going to be deemed null and void from legislation? That is just 1 other aspect (not including coding, reimbursement, benefits covered, administration, governing body, etc..., etc..., etc...)

Keep in mind: it's a 1/3 of the economy.

it's a mess for sure, and getting worse, rather than reducing waste and making what we have more efficient with the contracts, lawsuits and the usual government waste we just add more layers and barriers so the ignorant masses will stay that way. I've read and seen plenty about Canada's system, if you have lots of money you are fine, if you don't the wait times are unbelievable. then as you mentioned compare the tax rates etc How quickly people forget what kind of health plans our elected officials get and how they didn't want to give that up for obama care.

I mentioned it in passing yesterday that you were on a right track. From my participation and research of, do you know what would probably work best?

A la carte coverage with employer sponsored catastrophic (hospitalization). I can explain in much greater detail.
kevin24018
Posts: 1,843
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10/18/2016 2:08:08 PM
Posted: 1 month ago
At 10/18/2016 2:00:17 PM, Stymie13 wrote:
At 10/18/2016 1:54:22 PM, kevin24018 wrote:
At 10/18/2016 1:47:28 PM, Stymie13 wrote:
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?

But even that doesn't account for BUILDING and IMPLEMENTING single payer here.

It's estimated there are between 5 and 7 million contracts of varying sorts tied to the healthcare industry (I surmise higher). There are 3.5 million registered NPI's and each one has contracts with;

Payers
Medicaid
Clearing houses
Pms systems
Coding professionals
Lawyers
Accountants
Other practitioners
Ambulance services
Other BA (biz assoc) that do things transactionalky

You get the point. Are all those contracts going to be deemed null and void from legislation? That is just 1 other aspect (not including coding, reimbursement, benefits covered, administration, governing body, etc..., etc..., etc...)

Keep in mind: it's a 1/3 of the economy.

it's a mess for sure, and getting worse, rather than reducing waste and making what we have more efficient with the contracts, lawsuits and the usual government waste we just add more layers and barriers so the ignorant masses will stay that way. I've read and seen plenty about Canada's system, if you have lots of money you are fine, if you don't the wait times are unbelievable. then as you mentioned compare the tax rates etc How quickly people forget what kind of health plans our elected officials get and how they didn't want to give that up for obama care.

I mentioned it in passing yesterday that you were on a right track. From my participation and research of, do you know what would probably work best?

A la carte coverage with employer sponsored catastrophic (hospitalization). I can explain in much greater detail.

yes, but now we have the unaffordable care act so....but yeah some people don't need birth control etc but since the cost needs to be spread around (socialism) then some of us pay an inflated cost for things we don't need to offset the cost for those who do want it.
Stymie13
Posts: 2,162
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10/18/2016 2:15:31 PM
Posted: 1 month ago
At 10/18/2016 2:08:08 PM, kevin24018 wrote:
At 10/18/2016 2:00:17 PM, Stymie13 wrote:
At 10/18/2016 1:54:22 PM, kevin24018 wrote:
At 10/18/2016 1:47:28 PM, Stymie13 wrote:
At 10/18/2016 1:33:20 PM, kevin24018 wrote:
At 10/18/2016 1:00:59 PM, Stymie13 wrote:
Besides the concept of a 'free market' solution is a canard. It's not a free market now.

A free market solution is negotiating a rate with a practitioner, facility, and pharmacy on ones own. One can try that but most places will say no for a variety of reasons (I go back and forth with some practitioners I consult for to much amusement on both sides on this issue).

it's very muddy at best, factor in malpractice insurance and lawsuits, that is a huge part of why costs are what they are, so those who compare us to other countries need to look at all this crap and try to factor it in not just cherry pick.
The U.S. is a very rich country, but even so, it devotes far more of its economy " 17.6 percent of GDP in 2010 " to health than any other country.
Our data suggests that the U.S. does do more tests than other OECD countries.
The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:

A fear of litigation
http://www.pbs.org...

I mean it's been like that for a long long time, lots of waste, too much government involvement, a broken system which really needs revamping.
I'll bet it's even higher now
U.S. litigation costs overall are at least twice those in other developed countries, such as Canada and much of Europe, according to a 2008 study by the Manhattan Institute's Center for Legal Policy
http://www.amednews.com...

I've looked at other countries. There are some positives, and some negatives. Often they find themselves in the same place many here do: waiting to see a GP.

All you are saying, and even the things I was a bit dismissive on y'day (sorry about that)all play a part.

Since France is cited: France is a socialist country in regards to its social spending (their social security, their healthcare, etc...). In 2015, 53% of a person's income was deducted for social programs and taxes (lumped them both kind of like fed tax and FICA). Americans was 37%.

Now each person would have to do their own math but in which are you paying more?

But even that doesn't account for BUILDING and IMPLEMENTING single payer here.

It's estimated there are between 5 and 7 million contracts of varying sorts tied to the healthcare industry (I surmise higher). There are 3.5 million registered NPI's and each one has contracts with;

Payers
Medicaid
Clearing houses
Pms systems
Coding professionals
Lawyers
Accountants
Other practitioners
Ambulance services
Other BA (biz assoc) that do things transactionalky

You get the point. Are all those contracts going to be deemed null and void from legislation? That is just 1 other aspect (not including coding, reimbursement, benefits covered, administration, governing body, etc..., etc..., etc...)

Keep in mind: it's a 1/3 of the economy.

it's a mess for sure, and getting worse, rather than reducing waste and making what we have more efficient with the contracts, lawsuits and the usual government waste we just add more layers and barriers so the ignorant masses will stay that way. I've read and seen plenty about Canada's system, if you have lots of money you are fine, if you don't the wait times are unbelievable. then as you mentioned compare the tax rates etc How quickly people forget what kind of health plans our elected officials get and how they didn't want to give that up for obama care.

I mentioned it in passing yesterday that you were on a right track. From my participation and research of, do you know what would probably work best?

A la carte coverage with employer sponsored catastrophic (hospitalization). I can explain in much greater detail.

yes, but now we have the unaffordable care act so....but yeah some people don't need birth control etc but since the cost needs to be spread around (socialism) then some of us pay an inflated cost for things we don't need to offset the cost for those who do want it.

No doubt fed regs would need to change, as would states (DOI's at state level set min coverage for all approved plans).

What I'm saying is a 'disruption' (industry term) to the status quo vs the band aid stuff that is presently the case.

Again, very lengthy explanation. Lol
v3nesl
Posts: 4,489
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10/18/2016 2:25:23 PM
Posted: 1 month ago
At 10/18/2016 1:53:02 PM, Robkwoods wrote:
... I don't want to pay for your weekly psych visits. You pay for that.


I don't know, buddy, that might be a micro-aggression right there. Maybe even a mini-aggression. I think I better report you.
This space for rent.
Robkwoods
Posts: 570
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10/18/2016 2:28:03 PM
Posted: 1 month ago
At 10/18/2016 2:25:23 PM, v3nesl wrote:
At 10/18/2016 1:53:02 PM, Robkwoods wrote:
... I don't want to pay for your weekly psych visits. You pay for that.


I don't know, buddy, that might be a micro-aggression right there. Maybe even a mini-aggression. I think I better report you.

I knew they would get me one day.
Stymie13
Posts: 2,162
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10/18/2016 2:32:50 PM
Posted: 1 month ago
At 10/18/2016 2:25:23 PM, v3nesl wrote:
At 10/18/2016 1:53:02 PM, Robkwoods wrote:
... I don't want to pay for your weekly psych visits. You pay for that.


I don't know, buddy, that might be a micro-aggression right there. Maybe even a mini-aggression. I think I better report you.

That poster actually touched on an important aspect: catastrophic/major med was the original purview of employer based healthcare (and Medicare). Moving into the professional side of healthcare is what started the drive of all costs.. first premiums employers are, then copay/coinsurance/oop max, etc..., etc...
MakeSensePeopleDont
Posts: 1,104
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10/18/2016 4:01:20 PM
Posted: 1 month ago
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

You don't seem to understand free-market economies. You cannot have a free-market, but then say everyone must have access to whatever they want, which is a more socialistic style of economy. You creating a fantasy world there buddy.
kevin24018
Posts: 1,843
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10/18/2016 4:05:42 PM
Posted: 1 month ago
At 10/18/2016 4:01:20 PM, MakeSensePeopleDont wrote:
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

You don't seem to understand free-market economies. You cannot have a free-market, but then say everyone must have access to whatever they want, which is a more socialistic style of economy. You creating a fantasy world there buddy.

clearly it is fantasy there's no country that meets 1-3 totally unrealistic unless you are playing The Sims, that list goes way above and beyond what people actually need, guess we'll pay for breast implants because it would be a mental health issue or heck let's pay for tattoos for the same reason.
Stymie13
Posts: 2,162
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10/18/2016 4:22:45 PM
Posted: 1 month ago
At 10/18/2016 4:05:42 PM, kevin24018 wrote:
At 10/18/2016 4:01:20 PM, MakeSensePeopleDont wrote:
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

You don't seem to understand free-market economies. You cannot have a free-market, but then say everyone must have access to whatever they want, which is a more socialistic style of economy. You creating a fantasy world there buddy.

clearly it is fantasy there's no country that meets 1-3 totally unrealistic unless you are playing The Sims, that list goes way above and beyond what people actually need, guess we'll pay for breast implants because it would be a mental health issue or heck let's pay for tattoos for the same reason.

Tattoos and implants! Awesome. I have been aiming to get the Buckeyes on my right calf to match the Raiders on my left.

True story: when I was in basic (way back in the 90's), my sister flight had a TI (training instructor. Af is always different) change. Tiny thing, maybe 105. She just came off medical. Why? Implants (military paid for it back then)....

Ahhh the utilization of the past...
Greyparrot
Posts: 14,282
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10/18/2016 5:58:41 PM
Posted: 1 month ago
At 10/18/2016 4:22:45 PM, Stymie13 wrote:

Single payer medicine doesn't work for the same reason single payer public education does not work. One size consumption just does not fit all...and it should never be expected to.

People pay taxes to pay for public schools they don't even use, why would you think healthcare would be any different?

It will be a far crappier healthcare system for all, unless you can afford to buy your way out of the government system. For the rest of us, we get the scraps left by government lackeys. No thanks. Not everyone is happy with the public school system, and the same will not be happy with the quality of a single payer healthcare system either. Do you want to pay 150 dollars a month for cable TV to have channels you don't watch? No thanks, I am going with the dish for 50 dollars a month. Thanks.
Stymie13
Posts: 2,162
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10/18/2016 6:04:37 PM
Posted: 1 month ago
At 10/18/2016 5:58:41 PM, Greyparrot wrote:
At 10/18/2016 4:22:45 PM, Stymie13 wrote:

Single payer medicine doesn't work for the same reason single payer public education does not work. One size consumption just does not fit all...and it should never be expected to.

People pay taxes to pay for public schools they don't even use, why would you think healthcare would be any different?

It will be a far crappier healthcare system for all, unless you can afford to buy your way out of the government system. For the rest of us, we get the scraps left by government lackeys. No thanks. Not everyone is happy with the public school system, and the same will not be happy with the quality of a single payer healthcare system either. Do you want to pay 150 dollars a month for cable TV to have channels you don't watch? No thanks, I am going with the dish for 50 dollars a month. Thanks.

If you somehow gleamed I advocated a single payer system you are very mistaken. I did nothing but point out its administrative, financial, legal, regulatory, and delivery flaws.
Greyparrot
Posts: 14,282
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10/18/2016 6:08:22 PM
Posted: 1 month ago
At 10/18/2016 6:04:37 PM, Stymie13 wrote:
At 10/18/2016 5:58:41 PM, Greyparrot wrote:
At 10/18/2016 4:22:45 PM, Stymie13 wrote:

Single payer medicine doesn't work for the same reason single payer public education does not work. One size consumption just does not fit all...and it should never be expected to.

People pay taxes to pay for public schools they don't even use, why would you think healthcare would be any different?

It will be a far crappier healthcare system for all, unless you can afford to buy your way out of the government system. For the rest of us, we get the scraps left by government lackeys. No thanks. Not everyone is happy with the public school system, and the same will not be happy with the quality of a single payer healthcare system either. Do you want to pay 150 dollars a month for cable TV to have channels you don't watch? No thanks, I am going with the dish for 50 dollars a month. Thanks.

If you somehow gleamed I advocated a single payer system you are very mistaken. I did nothing but point out its administrative, financial, legal, regulatory, and delivery flaws.

Dammit, I wanted to rant!
Stymie13
Posts: 2,162
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10/18/2016 6:12:46 PM
Posted: 1 month ago
At 10/18/2016 6:08:22 PM, Greyparrot wrote:
At 10/18/2016 6:04:37 PM, Stymie13 wrote:
At 10/18/2016 5:58:41 PM, Greyparrot wrote:
At 10/18/2016 4:22:45 PM, Stymie13 wrote:

Single payer medicine doesn't work for the same reason single payer public education does not work. One size consumption just does not fit all...and it should never be expected to.

People pay taxes to pay for public schools they don't even use, why would you think healthcare would be any different?

It will be a far crappier healthcare system for all, unless you can afford to buy your way out of the government system. For the rest of us, we get the scraps left by government lackeys. No thanks. Not everyone is happy with the public school system, and the same will not be happy with the quality of a single payer healthcare system either. Do you want to pay 150 dollars a month for cable TV to have channels you don't watch? No thanks, I am going with the dish for 50 dollars a month. Thanks.

If you somehow gleamed I advocated a single payer system you are very mistaken. I did nothing but point out its administrative, financial, legal, regulatory, and delivery flaws.

Dammit, I wanted to rant!

Lol. Rant away! And fair enough :)
TeaPatriot
Posts: 203
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10/18/2016 9:11:37 PM
Posted: 1 month ago
At 10/18/2016 5:01:32 AM, augcaesarustus wrote:
Many people argue, primarily libertarians, that the free-market will make healthcare affordable and better quality; but they don't take into consideration one important thing, and it's this: when we implement economic policies, the problem we are faced with is: "how do we provide everyone with what they WANT?" in a world of scarcity.

You have to apply this logic to healthcare: "how do you provide every citizen in society with the healthcare he or she would ever want at any time in his/her lifetime?" This means the following:

i) people can access healthcare at any time, any day at little or no cost;
ii) there are no restrictions to how much they can use and what they can use (i.e. a person sees a psychologist every week at little or no cost);
iii) everyone in society should be able to afford the most expensive (emergency) treatment that could exist at any one given time, either at little or no cost, with no restrictions for use.
iv) the provision of that healthcare is unconditional, no matter what choices that person has made; irrespective of pre-existing conditions; and no matter what their condition is.

This is the extent (in policy terms) that free-market proponents have to be able to achieve using the free-market. So, my question is: can the free market achieve ALL of the foregoing? Remember, healthcare must be unconditional, accessible, at little or no cost to the the consumer.

Well see that's your problem. No system is perfect but the free market is helluva better option than a single payer system
Chairman of Economic Forum Recovery