The Economist on Healthcare

[ONW]

Not surprising. The same thing happens in Canada, although in a different way. Private insurance is illegal in Canada. So, rather than wait in the public system, people with the means to do so come to the US for treatment.

Did not know that.

 

[WFU71]

Really? You don't find anything compelling that every other industrialized country provides health care at a significantly lower rate than the one outlier, the US?

Do you believe the quality of care in those countries is equal to that in the US? I don't. Make the comparison apples to apples and we can talk.

I see from another post that you spent time in the UK. I served on a state-wide commission with a British MD (he was that state's Commissioner of Health). He talked at length about the system in the UK and the problems it created. I don't feel comfortable speaking for him other than to say he wasn't a fan of the system.

 

[BacktoBack]

I'd expand Medicare to all ages, but limit coverage to preventative and catastrophic events. I think the private insurance companies would then have a capped risk. Let them fight it out across state lines, but regulate them. I also believe the purchase of some product would have to mandatory so the "good lives" keep the insurance costs down and the foolish don't just depend on Medicaid. Subsidize the cost of insurance for lower income families. Use Medicaid to provide for those who legitimately fall thru the cracks.

I don't necessarily disagree with you, but we basically do this already. Patients without means are treated at ED's and tertiary care medical centers. The salary of a resident physician is paid by the federal government. By staffing tertiary care hospitals with large numbers of resident physicians-who are paid significantly less than staff physicians- we can afford to provide care to those without means. The bills are generally written off as charity care and the beat goes on. It's not like people are floundering outside the hospital doors looking for care and we won't provide it to them. Though I would certainly agree that we can and should do better for people.

 

[ONW]

Do you believe the quality of care in those countries is equal to that in the US? I don't. Make the comparison apples to apples and we can talk.

I see from another post that you spent time in the UK. I served on a state-wide commission with a British MD (he was that state's Commissioner of Health). He talked at length about the system in the UK and the problems it created. I don't feel comfortable speaking for him other than to say he wasn't a fan of the system.

Quality of care is certainly a concern, but we also eat all PPO's, HMO's, and Pharmaceutical R&D. Honestly, I'm conflicted on this issue.

 

[ONW]

I don't necessarily disagree with you, but we basically do this already. Patients without means are treated at ED's and tertiary care medical centers. The salary of a resident physician is paid by the federal government. By staffing tertiary care hospitals with large numbers of resident physicians-who are paid significantly less than staff physicians- we can afford to provide care to those without means. The bills are generally written off as charity care and the beat goes on. It's not like people are floundering outside the hospital doors looking for care and we won't provide it to them. Though I would certainly agree that we can and should do better for people.

Dr's take an oath that for profit hospitals dont.

 

[WFU71]

Dr's take an oath that for profit hospitals dont.

I'm not a hospital guy, but have worked in both the proprietary and non-profit healthcare fields. I also dealt with hospitals throughout my career. Overall there I saw little difference based on profit motive. Non-profits endeavor to make as much not-for-profit as they can.

 

[RJKarl]

Competing across state lines will lead to virtual monopolies. Many states already have virtual monopolies.

If the big comnpanies are allowed to compete across state lines they will consolidate their stranglehold in the marketplace.

It sounds like a great idea in the abstract but not in practice.

I would also not be surprised to see companies be incorporated in states that offer consumers little to no recourse like the banks have done with credit card operations in states that allow much higher interest rates than allowed in their own states.

 

[ONW]

I'm not a hospital guy, but have worked in both the proprietary and non-profit healthcare fields. I also dealt with hospitals throughout my career. Overall there I saw little difference based on profit motive. Non-profits endeavor to make as much not-for-profit as they can.

Interesting. Appreciate your candor.

 

[WFU71]

Interesting. Appreciate your candor.

I'm retired, so I'm not conflicted by an employer or B/D.

 

[deac85]

I'm retired, so I'm not conflicted by an employer or B/D.

I hear you, spot on!

 

[WFU71]

Competing across state lines will lead to virtual monopolies. Many states already have virtual monopolies.

If the big comnpanies are allowed to compete across state lines they will consolidate their stranglehold in the marketplace.

It sounds like a great idea in the abstract but not in practice.

I would also not be surprised to see companies be incorporated in states that offer consumers little to no recourse like the banks have done with credit card operations in states that allow much higher interest rates than allowed in their own states.

I guess you missed the part where I said to regulate the sale of insurance across state lines.

 

[ONW]

I'm retired, so I'm not conflicted by an employer or B/D.

Well done. I'm about 28 years behind you.

 

[pourdeac]

But beyond the added expense, why would anyone think that a system in which marketing plays such a large role is likely to be more effective, to lead to better treatment, than the kind of process of expert review that governs grant awards at NIH or publishing decisions at peer-reviewed journals?"

Bwhahahahaha. That comment is insane. I am part of that system and complete religious-like faith in academic "experts" is half the problem, including these economists who want to naively attack a capitalist health system. The FDA has already basically ruined CNS drug discovery in the US by requiring thresholds of activity where existing treatments exist...even if grossly inadequate. That's what gov regulation does.

The US health system costs more because we do more and have a broader set of health issues, in large part due to our unique willingness to accept gobs of immigrants and thus have a greater genetic diversity. Plus we subsidize the world's health care by our cutting edge and often costly (initially) treatments. That's never accounted for by these economic "experts".

 

[RJKarl]

I guess you missed the part where I said to regulate the sale of insurance across state lines.

I didn't see that, but it's also not part of what those who typically support that concept want. They are typically AGAINST nearly all regulation.

Let the market fix any problems they say.

 

[WFU71]

I didn't see that, but it's also not part of what those who typically support that concept want. They are typically AGAINST nearly all regulation.

Let the market fix any problems they say.

Well, I'm not one of them. Your concern over monopolies is shared. I'm not against all regulations - just the stupid ones. One small thing I'd make the insurance companies do is have their call centers in the US. Dealing with insurance people is hard enough without having to figure out what in the hell they are saying.

 

[ONW]

Bwhahahahaha. That comment is insane. I am part of that system and complete religious-like faith in academic "experts" is half the problem, including these economists who want to naively attack a capitalist health system. The FDA has already basically ruined CNS drug discovery in the US by requiring thresholds of activity where existing treatments exist...even if grossly inadequate. That's what gov regulation does.

The US health system costs more because we do more and have a broader set of health issues, in large part due to our unique willingness to accept gobs of immigrants and thus have a greater genetic diversity. Plus we subsidize the world's health care by our cutting edge and often costly (initially) treatments. That's never accounted for by these economic "experts".[/QUOTE]

2nd bit I agree with, 1st part, wow.

 

[ONW]

Well, I'm not one of them. Your concern over monopolies is shared. I'm not against all regulations - just the stupid ones. One small thing I'd make the insurance companies do is have their call centers in the US. Dealing with insurance people is hard enough without having to figure out what in the hell they are saying.

What? Sue told me she lived in St.Louis!

 

[RJKarl]

Well, I'm not one of them. Your concern over monopolies is shared. I'm not against all regulations - just the stupid ones. One small thing I'd make the insurance companies do is have their call centers in the US. Dealing with insurance people is hard enough without having to figure out what in the hell they are saying.

also the rules for coverage need to be for the state in which you reside not where the company is...and there needs to be baseline for coverage.

The penalties for delaying or not covering across statelines need to be very steep and very quick. With a number certain that disqualifies a company from serving across state lines.

 

[EatLeadCommie]

I don't understand the point of the original post. Even when you go to the link, it just rambles on about some irrelevant marketing thing and never makes much of a point. The notion that HC costs are somehow cheaper elsewhere is largely a fallacy. The governments in Europe and elsewhere artificially control costs with subsidies, and the rest of the "free" and "cheap" health care is covered by ridiculous tax rates that nobody in the US will be willing to pay.

 

[Shorty]

I don't understand the point of the original post. Even when you go to the link, it just rambles on about some irrelevant marketing thing and never makes much of a point. The notion that HC costs are somehow cheaper elsewhere is largely a fallacy. The governments in Europe and elsewhere artificially control costs with subsidies, and the rest of the "free" and "cheap" health care is covered by ridiculous tax rates that nobody in the US will be willing to pay.

Germans have 14% taken out of their "pay packets" for sickness funds as is.