Originally Posted by Steeeeve

So in short the best case scenario is we go from $6,000 per capita to.......$6,000 per capita. Basically this would mean less care for the already insured

This is misleading. You will not get the care that is irrelevant to your health. For example when a straight X-ray will do you will not get an MRI scan. When one scan will do you will not get two. Your sprained ankle will heal just as well.

Originally Posted by modulus

This is misleading. You will not get the care that is irrelevant to your health. For example when a straight X-ray will do you will not get an MRI scan. When one scan will do you will not get two. Your sprained ankle will heal just as well.

This isn't misleading at all. You pay the same per capita...we've been over this. If you have more people using the system and the same number of doctors you will have a harder time seeing a doctor. This is assuming economics doesn't work and higher demand means same price.

Why can't you just admit the costs that are there?

Originally Posted by Steeeeve

This isn't misleading at all. You pay the same per capita...we've been over this. If you have more people using the system and the same number of doctors you will have a harder time seeing a doctor. This is assuming economics doesn't work and higher demand means same price.

Why can't you just admit the costs that are there?

I am having difficulties following your logic. I cannot even decipher your last sentence. For the last and final time. We are paying twice as much as the rest of OECD for the same (or worse) quality of service and the same number of doctors per capita (or fewer.) As Daewoo pointed out the waiting time for a doctor is shorter in the U.K. than in the U.S.

You seem to asume that the healthcare cost is incurrred solely due to doctor's salaries. This assumption is false. There are other costs that can be reduced.

Originally Posted by modulus

I am having difficulties following your logic. I cannot even decipher your last sentence. For the last and final time. We are paying twice as much as the rest of OECD for the same (or worse) quality of service and the same number of doctors per capita (or fewer.)

You seem to asume that the healthcare cost is incurrred solely due to doctor's salaries. This assumption is false. There are other costs that can be reduced.

You seem to not get what I am asking. You just said we are paying twice as much...I agree. Where does this bill change that? in order for those costs to come down someone has to get paid less. It doesn't have to be doctors but it has to be someone. It can't all be health insurance companies (and isn't) and it doesn't seem reasonable that it is just people getting less. It seems we will also have less of something. Just tell me in the Senate Bill what this is. "We will get from $6,000 per capita to $4,000 per capita by eliminating _____________ or paying _________ less". AKA jobs lost. If you build less MRI machines those people loss a job. If you do less tests the people doing the tests loss a job.

Now, if you keep the same costs this is not true but you don't fix the one thing you always complain about...that the US pays twice as much.

Originally Posted by modulus

As Daewoo pointed out the waiting time for a doctor is shorter in the U.K. than in the U.S.

But not Canada and this ONLY applies to primary care physicians and NOT specialists. If you look at specialists and non-emergency procedures the wait time for the US is substantially better.

I don't get how my question is throwing you off so much.

Originally Posted by Steeeeve

This is true for primary care doctors but not specialists and procedures such as getting an MRI for your broken foot (ha). The US has a hell of a lot more equipment than the UK and Canada. I've been to hospitals doing some accounting consulting work and ask to see a $150,000 piece of equipment and they will have to dig it out of the back saying "yeah, we've never used it". You might think the free market thing is a myth but if you did have "free market" you'd have exactly the number of MRI and CT machines that the pubic wanted. Whether this is a good thing or not could be debated. I think the problem with the UK and Canada is they have no idea what a good number should be.

I would agree with this...personally I think it has to be something like (not the same) the Swiss or something that accepts a true free market system would say some of the poor may die and thus has very limited government interaction to address that reality.

This is the bottom line. We have to make up our minds. Either we are for social Darwinism or we are not. In the first case we have to eject the people without insurance from the emergency rooms and cancer hospitals on the street. If we are not prepared to do that than it is far better to force them to pay a fair share of their insurance uprfront.

To me the consideration if it is free market or if it conforms to the Austrian School of Economics dogma is secondary. People are not a commodity, the human life is not a commodity and human health is not a commodity.

Originally Posted by modulus

This is the bottom line. We have to make up our minds. Either we are for social Darwinism or we are not. In the first case we have to eject the people without insurance from the emergency rooms and cancer hospitals on the street. If we are not prepared to do that than it is far better to force them to pay a fair share of their insurance uprfront.

To me the consideration if it is free market or if it conforms to the Austrian School of Economics dogma is secondary. People are not a commodity, the human life is not a commodity and human health is not a commodity.

Fine, but yet again this doesn't address what I am asking. Are you avoiding it or what? Does the Senate Bill supposedly being voted on today have anything in it that will lower our health care costs PER CAPITA? If yes, what are those cuts and who ends up without a job or less money? If no, then are we really going to give 32 million people health insurance for 6 years at a cost of 940 billion? Seems a little low for health insurance.

Originally Posted by Steeeeve

Fine, but yet again this doesn't address what I am asking. Are you avoiding it or what? Does the Senate Bill supposedly being voted on today have anything in it that will lower our health care costs PER CAPITA? If yes, what are those cuts and who ends up without a job or less money? If no, then are we really going to give 32 million people health insurance for 6 years at a cost of 940 billion? Seems a little low for health insurance.

It is low because of the savings.

Originally Posted by modulus

It is low because of the savings.

Can you answer my question already or do you just not know?

Originally Posted by Steeeeve

This is true for primary care doctors but not specialists and procedures such as getting an MRI for your broken foot (ha). The US has a hell of a lot more equipment than the UK and Canada. I've been to hospitals doing some accounting consulting work and ask to see a $150,000 piece of equipment and they will have to dig it out of the back saying "yeah, we've never used it". You might think the free market thing is a myth but if you did have "free market" you'd have exactly the number of MRI and CT machines that the pubic wanted. Whether this is a good thing or not could be debated. I think the problem with the UK and Canada is they have no idea what a good number should be.

It is especially true of specialists. Try to get an appointment with a urologist. If you are "lucky" you will be suffering from some terrible severe condition and they will squeeze you in quickly. If it is something unimportant, like you think you have prostate cancer, plan on waiting a few weeks.

"Free market" health care is a myth for a couple of reasons. First of all, dying is not a consumer choice. "Do it or die" pretty much sucks all the consumer choice out of the system. At BEST it is a captive market.

Second, only a complete and utter fool would call what we have here in the US a free market system because pharma companies, medical device manufacturers, and even doctors via the AMA have pretty much purchased the laws they need to stifle competition and ensure dominance in the market. From patent laws to certification requirements to approval of new procedures, the companies and organizations that are currently dominate in US health care have ensured their continued dominance.

I would agree with this...personally I think it has to be something like (not the same) the Swiss or something that accepts a true free market system would say some of the poor may die and thus has very limited government interaction to address that reality.

IMO if we could break through the stupidity barrier it would make things a lot easier. We have ended up in this ludicrous situation where there seem to be a bunch of people unwilling to admit that there is anything wrong with our current system because they have come to the conclusion that if they admit there IS something wrong, the only solution will be socialized medicine. If health care cost continue to grow at their current rate by 2025 nearly half our GDP will go JUST to health care. How can ANYBODY not see that this is a problem?????? It is insane.

Originally Posted by Steeeeve

This isn't misleading at all. You pay the same per capita...we've been over this. If you have more people using the system and the same number of doctors you will have a harder time seeing a doctor. This is assuming economics doesn't work and higher demand means same price.

Why can't you just admit the costs that are there?

In theory more coverage for more people will result in decreased per capita costs.

Lets say you are insured and your health care costs are $4000 per year. Lets say that Modulus is not insured. He gets a kidney stone, but cannot afford to go to the doctor. So he takes a bunch of tylenol, advil, and whatever painkillers he can find on the street.

The kidney stone continues to grow until it blocks the flow from that kidney. The kindney swells up until the pain is so bad he cannot take it anymore. He goes to the ER when his kidney finally bursts and he is septic. Emergency surgery. 3 weeks on IV antibiotics. $500,000. HE gets out of the hospital, goes chapter 7. The hospital eats that half million.

Between the 2 of you, per capita health care cost is $252,000 for that year.

Now, scenario 2.

You have an average health care expenditure of $4,000 per year. Modulus is now insured. He gets a kidney stone. He goes to the doctor because it hurts like hell. The doctor visit cost $60. He has a $70 x-ray. They fidn the stone and send him to a urologist, which costs $120. They put in a stent, shove a laser up the end of his willy, and zap that bad boy. Total cost is about $4200 for the procedure. Figure another $120 for pain killers (during the wait for the urologist he is going to need some percocet). Total cost....$4,570

Now your per capita cost is $4,285

That is a very real phenomenon. I know our local hospital actually wrote off more accounts than they collected last year. That means they have to increase prices in order to cover their expenses.

That is why an MRI at our local hospital cost $6800 OR I can go to topeka to a special MRI clinic and it only costs $2400 there. The hospital HAS TO treat everybody who comes through the door and they end up with a bunch of noncollectable accounts. The MRI clinic requires payment in advance. Everybody pays so they dont have to build the cost of the deadbeats into their pricing.

The theory is sound. I am not familiar enough with the new bill to know if the implementation is worth spitting on, but if we can turn Modulus kidney stone from a half million dollar ordeal to a $4500 pain in the back, the savings more than make up for the expense.

Originally Posted by daewoo

It is especially true of specialists. Try to get an appointment with a urologist. If you are "lucky" you will be suffering from some terrible severe condition and they will squeeze you in quickly. If it is something unimportant, like you think you have prostate cancer, plan on waiting a few weeks.

Every study I have seen has indicated otherwise including the more famous one...err...can't think of it right now..commonwealth fund or something? Yup, that's it.

Originally Posted by Commonwealth Fund Study

The U.K (60%) and Canada (57%) had the highest numbers of persons who had to wait four weeks or more to get to see a specialist physician. In the U.S., only 23% reported a wait of four weeks or more for specialty care.

In fact, we probably have too few physicians because we have so many specialist. It pays much more for arguably easier work.

"Free market" health care is a myth for a couple of reasons. First of all, dying is not a consumer choice. "Do it or die" pretty much sucks all the consumer choice out of the system. At BEST it is a captive market.

Well, you could make it a free market choice but you'd have the option of letting people die. I agree it isn't wise to do it this way.

Second, only a complete and utter fool would call what we have here in the US a free market system because pharma companies, medical device manufacturers, and even doctors via the AMA have pretty much purchased the laws they need to stifle competition and ensure dominance in the market. From patent laws to certification requirements to approval of new procedures, the companies and organizations that are currently dominate in US health care have ensured their continued dominance.

No one argues with this...we were probably closer to Canada than we thought

IMO if we could break through the stupidity barrier it would make things a lot easier. We have ended up in this ludicrous situation where there seem to be a bunch of people unwilling to admit that there is anything wrong with our current system because they have come to the conclusion that if they admit there IS something wrong, the only solution will be socialized medicine. If health care cost continue to grow at their current rate by 2025 nearly half our GDP will go JUST to health care. How can ANYBODY not see that this is a problem?????? It is insane.

Oh something it wrong and Warren Buffet had it right when he said it wasn't the health insurance companies. The problem has been and will be cost. Banning employer based health care is probably the one idea that is undeniably helpful yet not a peep out of congress on that one.

Originally Posted by daewoo

The theory is sound. I am not familiar enough with the new bill to know if the implementation is worth spitting on, but if we can turn Modulus kidney stone from a half million dollar ordeal to a $4500 pain in the back, the savings more than make up for the expense.

And my point is that if the hospital is out a half million (because they don't just eat it they increase other costs to basically cover it...they aren't running a charity) You cover that decrease in revenue by cutting something. It is either people, equipment (which will end up as the ones building it), or both. Now if you DO NOT drop costs in anyway..ie you don't plan on anyone getting canned then by definition your per capita costs do not go down. Do you see what I am saying with that? I'm not arguing that we shouldn't have people get tests sooner, I'm just saying that the results of cuts will be jobs lost somewhere along the line. The question is where do you want that to be.

Originally Posted by daewoo

The theory is sound. I am not familiar enough with the new bill to know if the implementation is worth spitting on, but if we can turn Modulus kidney stone from a half million dollar ordeal to a $4500 pain in the back, the savings more than make up for the expense.

As far as I am aware, the research on "preventative" medicine shows that it is only preventative "lifestyle choices" that decrease costs.

e.g. losing weight or quitting smoking is a cost-saving form of preventative medicine.

Having an exploratory rectal probing every 24 months to look for the early signs of bowel cancer may improve life expectancy, but will increase costs. Part of the reason is false positives, which are inevitable. Part is people find and treat diseases that would have affected them so much later they would have died of something else already anyway.

Modulus has attempted to address the savings issue, stating

By attacking the demand that leads to overconsumption of services, the bills should slow the growth of healthcare costs over the long term.

In other words, costs will be saved by reducing "over"consumption of services, instead rationing them out at a pace the government decides is appropriate and efficient.

Originally Posted by Symbiote

As far as I am aware, the research on "preventative" medicine shows that it is only preventative "lifestyle choices" that decrease costs.

e.g. losing weight or quitting smoking is a cost-saving form of preventative medicine.

Having an exploratory rectal probing every 24 months to look for the early signs of bowel cancer may improve life expectancy, but will increase costs. Part of the reason is false positives, which are inevitable. Part is people find and treat diseases that would have affected them so much later they would have died of something else already anyway.

Modulus has attempted to address the savings issue, stating



In other words, costs will be saved by reducing "over"consumption of services, instead rationing them out at a pace the government decides is appropriate and efficient.

I haven't looked into this enough to comment on it even though I have done it in the past.

I did find this:

PolitiFact | Obama says preventive care saves money. It doesn't.

Originally Posted by Politifact

One of those benefits, he said, is that insurers will be required to cover checkups and other preventive care.

"Insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies — because there’s no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse," Obama said. "That makes sense, it saves money, and it saves lives."

It may make sense and save lives, but does it save money? Experts say no.

I'd be interested to know if there are good studies on this or if it "depends" on the situation.