Healthcare Debate Hits The Floor

[mr.72]

The problem of course is that health care is not like car insurance. As an absolute, unless you halt on an absolute basis technology and drug development, the cost of healthcare per person is going to rise. All those neat gadgets cost gobs of money. If you're going to have those neat gadgets then the cost is going to go up. After all, we went back to 1920s era healthcare, we could afford that with ease, but most of us would be dead before we hit 60...

No, the cost of "healthcare" is not going to rise. The price range of health care is going to expand.

If I go to the Dr. once a year for a routine checkup or because I have a bike wreck and bruise a rib or whatever then it doesn't matter if it's 1989, 1999 or 2009, the actual cost of that visit is exactly the same year over year. Certainly if I have an illness that was previously untreatable but now can be fixed with some new, expensive treatment then the option of a more expensive treatment has arisen as an alternative to dying, but that's not the cost of health care going up, it's the availability of treatment being expanded.

Either way, I don't want to have to subsidize your abuse of these newfangled expensive treatments with my health insurance premiums when I choose not to use them. I am allergic to penicillin, so why should I pay for these expensive three-day penicillin-based antibiotic treatments for you? We are done having children, so why should I pay for your maternity care? Or fertility treatments? I don't do risky sports, why should I subsidize your ACL surgery? I don't ride motorcycles, so why should I pay for your head injuries? Why can't I choose to buy a health insurance policy that meets my needs without subsidizing yours? I promise I can control MY health care costs, but it requires me to be free to choose not to pay for yours.

Of course, the whole purpose of the current health "care" plan the gov't is trying to enact is to force all of us to pay for those who are a poor insurance risk and also who are unable to pay. That's actually kind of the purpose of all big-government programs, to force me to pay for your bad lifestyle, poor choices, or misfortune, which you cannot pay on your own.

"you" here being the "collective you", that is, those other than me, and not you in particular.

[chabouk]

The problem of course is that health care is not like car insurance.

What a shame it's not.

If people used car insurance like they use health insurance, they'd be filing claims for every oil change and tire rotation.

People use health insurance for routine visits, which means they have no idea how much those visits cost. If they knew, I guarantee they wouldn't cost as much, because people would simply reject it and find a cheaper provider.

Have you ever wondered why medical procedures that aren't covered by most insurance, like Lasik, keep going down in price even as other healthcare costs increase? Well, here you go:

http://reason.tv/video/show/how-to-fix-health-care" onclick="window.open(this.href);return false;

[ChuckW]

A lot of good points are being made here but an important point that some are missing is that health care is not like other services/products where you and I as consumers have the opportunity to shop for the best price/quality combination. If you need body work on your car you are going to shop for a place that does quality work at a minimum price. If you are shopping for a new HD TV, you are going to buy one that meets your technical standards at the lowest cost that you can find.

Health care costs, to a large degree, are not controlled by the patient. If you have been injured in an auto accident you are not going to shop around for the best deal, you are most likely going to accept anything and everything that the doctor recommends. Same thing for a heart attack or any other serious illness. The same thing is largely true even for a simple thing like an annual physical. If the doctor highly recommends a particular diagnostic procedure, how many patients (health care consumers) are sufficiently knowledgeable to be able to question that recommendation?

I spent many years as a benefits manager in a large corporation and wrestled with these questions daily. The fact is that the medical care consumer just does not have the control that we have in other purchasing situations. I am not advocating either government run or a totally private health care model here; I am just saying that any solution that does not give the patient some expert backup is guaranteed to keep medical costs on a severely upward spiral.

[mr.72]

Health care costs, to a large degree, are not controlled by the patient. If you have been injured in an auto accident you are not going to shop around for the best deal, you are most likely going to accept anything and everything that the doctor recommends. Same thing for a heart attack or any other serious illness. The same thing is largely true even for a simple thing like an annual physical. If the doctor highly recommends a particular diagnostic procedure, how many patients (health care consumers) are sufficiently knowledgeable to be able to question that recommendation?

So since the consumer is presumed to be ignorant and incapable of making these decisions, we need to make sure they get made by some bureaucrat or senators who didn't even read the bill? Or by the Dr. who also happens to gain from the most expensive of the options?

The solution to the problem you suggested is for consumers of health care services to become educated. Buyer beware! Yeah, maybe if it's a car accident, sure thing. But if you don't have any symptoms of a problem whose diagnosis is improved with an MRI, then there is no need for an MRI.

I have refused procedures quite frequently, including while I was in the hospital following surgery. It really ticks off the doctors when they are reminded that they are not in control. But they adapt.

[ChuckW]

Health care costs, to a large degree, are not controlled by the patient. If you have been injured in an auto accident you are not going to shop around for the best deal, you are most likely going to accept anything and everything that the doctor recommends. Same thing for a heart attack or any other serious illness. The same thing is largely true even for a simple thing like an annual physical. If the doctor highly recommends a particular diagnostic procedure, how many patients (health care consumers) are sufficiently knowledgeable to be able to question that recommendation?

So since the consumer is presumed to be ignorant and incapable of making these decisions, we need to make sure they get made by some bureaucrat or senators who didn't even read the bill? Or by the Dr. who also happens to gain from the most expensive of the options?

The solution to the problem you suggested is for consumers of health care services to become educated. Buyer beware! Yeah, maybe if it's a car accident, sure thing. But if you don't have any symptoms of a problem whose diagnosis is improved with an MRI, then there is no need for an MRI.

I have refused procedures quite frequently, including while I was in the hospital following surgery. It really ticks off the doctors when they are reminded that they are not in control. But they adapt.

If you can keep up with medical science so that you know the true medical worth of both common and uncommon medical procedures more power to you! The average person has a very tough time knowing enough about the mechanics of a modern automobile to know whether or not a mechanic is scamming them let alone knowing enough about medical science and human ailments.

I certainly did not suggest that some bureaucrat or senator make make medical decisions. And, my whole previous statement was meant to indicate that the doctor who stands to gain the most ordering expensive options is the among the worst to rely on. What is needed is some independent unbiased backup help available to patients. Sort of an immediately available second opinion.

[pdubyoo]

I certainly did not suggest that some bureaucrat or senator make make medical decisions. And, my whole previous statement was meant to indicate that the doctor who stands to gain the most ordering expensive options is the among the worst to rely on. What is needed is some independent unbiased backup help available to patients. Sort of an immediately available second opinion.

I somewhat see the point that you are trying to make, but I don't completely agree with you. Any time I have had medical treatment, including back surgery, I have been the one that makes the final decision of what treatment I receive. Not the doctor. Now, that doctor that I have chosen to advise me is specially trained in his field, to make compelling recommendations and/or offer specific advice. I respect that training, and trust his/her advice, but he/she is human, and can mis-diagnose a problem. If I'm not completely comfortable with what I'm being told, I am currently free to seek a 2nd, 3rd, 4th opinions. It is certain that gooberment-run healthcare will not allow that freedom.

Further, the finest medical doctors are practicing medicine right now. Whatever their motivation for practicing...be it financial gain, passion, charity...the best of the best are practicing medicine today. Go ask how many of those best of the best doctors how long they are going to practice medicine under federal-bureaucratic terms, and I bet the answer is shocking. I have asked some, including my very well-respected orthopaedic surgeon, and some say they'll likely continue practice with great reservations, one said he wasn't sure, and one said he will retire very early and enjoy life.

The point I'm trying to make is this...federal bureaucracy will drive the best of the best out of practice, and that will ultimately hurt all of us. The best doctors teach the rest.

[Dudley]

We are done having children, so why should I pay for your maternity care? Or fertility treatments?

Why should people without children pay for schools?

[marksiwel]

We are done having children, so why should I pay for your maternity care? Or fertility treatments?

Why should people without children pay for schools?

those kids are going to grow up and change your depends thats why. They are the future, believe it or not.

Back to healthcare.

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

[pdubyoo]

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

I can only speak for myself, but to answer your question...YES, I'm very happy with my current insurance. Could it be better? Certainly. The healthcare and insurance industries need reform. But that's not what you're asking. So, yes, I'm happy with my insurance. I pay for half of it, and my employer pays the other half, and it's not cheap, but it's good. Dealing with the insurance company on issues has been, allbeit rare, challenging. It's not utopia, but it is light years better than my personal experiences dealing with ANY gooberment entity (USPS, DPS, IRS, etc.).

Regarding issues with my insurance company...when I have had a problem getting an issue resolved, my employer leans on them and gets it resolved. Why, because my employer represents volume, and me and my employer paid for certain services with certain expectations. It's called capitalism.

TRY THAT WITH THE GOOBERMENT!!! That's a challenge!

[mr.72]

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

At least when it happens with a private company, you have the choice to go elsewhere or you can just simply cancel it and stop paying.

Try that when it happens with your government-provided health insurance, and you try and stop paying your taxes.

If you think it's a pain to move to a different company to change health insurance, well in the future we will have to move to a different COUNTRY to change health insurance.

And FWIW, the answer is to let me change health insurance without changing companies... but I have said this before so many times and we are all so used to having someone else pay for our health insurance that we can't see through to making our own choices.

[Zee]

As a provider I agree to acccept the rate insurance companies pay. These can range from sort of low up to almost OK. If I refuse their rates I refuse those clients with the insurance. For uninsured I work from free to low. This let's most potential clients come in and I get some walking around money and a good feeling. For me its an ongoing compromise.

[Liberty]

The problem of course is that health care is not like car insurance. As an absolute, unless you halt on an absolute basis technology and drug development, the cost of healthcare per person is going to rise. All those neat gadgets cost gobs of money. If you're going to have those neat gadgets then the cost is going to go up. After all, we went back to 1920s era healthcare, we could afford that with ease, but most of us would be dead before we hit 60...

One might question whether a longer life is a worthwhile trade off for a life of servitude, or slavery, and the having our children indentured to a lifetime of such servitude. Its worth considering what is a few more years worth, and who gets to make these decisions for us. A free shorter life might be more value to its owner than a life of servitude to the insurance companies and the Government. Hopefully we should be able to make these types of choices for ourselves.

[marksiwel]

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

At least when it happens with a private company, you have the choice to go elsewhere or you can just simply cancel it and stop paying.

Try that when it happens with your government-provided health insurance, and you try and stop paying your taxes.

If you think it's a pain to move to a different company to change health insurance, well in the future we will have to move to a different COUNTRY to change health insurance.

And FWIW, the answer is to let me change health insurance without changing companies... but I have said this before so many times and we are all so used to having someone else pay for our health insurance that we can't see through to making our own choices.

You know its almost impossible to vote out a private company, it can happen with a government run body, it aint easy but it can happen.
The Insurance companies have us by the short hairs. As for being forced to pay for it, I believe that it should be like the Mass plan I was on when I lived in Boston, your insurance has to meet X,Y, and Z measures, if they do you dont have to inrole in the Mass plan, and are not fined.
If anything introducing REAL competition into insurance companies could get you better insurance with more benefits. The people of Sweden, Japan, Finland have a great model for Health Insurance, we should be taking note from them, not from Canada and the UK.

Its going to happen, its a matter of time, if they are going to do it, it had better be the best damn plan ever.

[Dudley]

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

They're not perfect but they do a much better job than the government. For less money to boot.

[marksiwel]

So, everyone here is happy with their insurance and have never been screwed over or denied a claim by their insurance company?

They're not perfect but they do a much better job than the government. For less money to boot.

How do you know they do a better job if we have never had the goverment do it! Medicare and medicade are great programs and my parents love them.

Also you will still have the option of private insurance.

So much misinformation out there