>>So your theory is that doctors don't care about compensation
No, what I said was doctors care about healing people. (Well, I said the opposite, but that was sarcasm.)
I'm friends with a number of doctors and pharmacists at the local large regional hospital. Married to one, in fact. The fear of malpractice lawsuits has a huge, and negative, impact on patient care. What is euphemistically called Defensive Medicine means that doctors run tests and procedures they don't need to because trial lawyers have made doctors liable for people getting sick.
Doctors are definitely driven by compensation, as any analysis of medicare billing will reveal. Certain procedures are profitable, certain ones are not (fixed payments at below cost). Guess which procedures get done more? And then tell me this is good for health care with a straight face.
>>That means doctors and hospitals will make 30% less money if malpractice is eliminated.
Uh... yeah. You're completely detached from reality. One of the reasons Kaiser is cost competitive is because you waive your right to sue them for malpractice. In your other post you mention that you have to agree to binding arbitration instead, and having seen that process, let me tell you that you'd never get $100M out of an arbiter because your baby was born a month early. In fact, since Kaiser runs all their business through AAA, I think that they probably have an illegal bias.
The notion that lawsuits improves patient care has been conclusively disproven. Do yourself a favor and start researching the issue yourself.
Are you saying that this is optimal even given the penalties you'll be assessed if you don't have health insurance? I haven't looked at the numbers, are the penalties significantly lower than insurance is likely to be for a healthy individual given the fact that those are the prices most likely to go down after the bill is in full effect?
Yep. The fine (well, tax) is $600/year. You can't get health insurance for that cheap.
Care to lay a bet on it? The CBO estimates can be accurate AND the bill can increase the deficit. If you don't understand why, re-read what I said again.
>>If there were no malpractice lawsuits, the quality of medical care will definitely be worse
Yes, because doctors certainly don't care about healing people.:p
Guess what - in Kaiser, you can't sue them for malpractice. And you still get Good Enough(tm) care from Kaiser.
In fact, it has been pretty conclusively proven that medical lawsuits harm medical practice rather than helping it. Doctors generally try to do what's best for patients, but when you get into CYA situations a lot of extra tests and surgeries start getting done.
Either text citations from the actual bill or sarcasm flags are needed, in a big way! This is the first I've seen, even the most paranoid screed about this bill, anyone claim HSAs were going to be outlawed. Now my understanding is that they aren't going to be incentivized like some wanted them to, but that's far from outlawing them
They're going to be de facto outlawed, not de jure.
>>I'm guessing that "'Ndrangheta boss" counts for more than "uses facebook" when it comes to calculating an individual's ranking in the criminal respect index.
Yeah, but tweeting your crimes is definitely worth -50 points.
>>But one of the scenes from "Sicko" that really stuck with me was of the man who accidentally cut off a couple of fingertips, and got a choice of which finger they should reattach (he couldn't afford them both).
I watched sicko. You probably shouldn't rely too much on it for factual information. You'd believe that ERs turn away people that can't pay, even though it is against the law for them to do so (and has been for 20 or 30 years now).
You claim to be a small business owner. What would the IRS think, if you marked the price of a used worn out blank USB stick as $10M, sold it to me, and I never paid you, or we settled for 25 cents total? Then on your income tax you enter a "$10M" business loss, thus you don't have to pay income taxes this year because that "loss" cancels out all your revenue?
I am a small business owner.
Forgiving the debt counts as income, so it doesn't help at all.
But you're right, hospital billing is based on fraud - but on both sides.
>>I don't know how many visits to a GP are needed to outweigh a month in the ICU, but I suspect it's quite a lot.
It's not theory, though. Actual analysis of real numbers shows that costs increase as you make more care available. Make doctors free, and medical costs go through the roof - it's just not the patients paying to see them any more.
>>some brilliant money-making idea that requires $0 start-up you're in for a long ride till your first real profit.
Lol, my family's small business was a brilliant money-making idea that had close to no start-up fees (business license I guess, but that's cheap, and a server). So everything was profit. BUT - you have to consider the value of your time. If I spend all year making $1,000 when I could be making $100,000 as a W2 earner, then the business isn't worth it. And when you're a small business, getting business is the hardest obstacle to overcome. Red tape is annoying, but just getting the word out there that your business exists is really the hardest part.
I made a promise to my mom and dad that I'd give them two years of my life to try to make the company happen (tech company without me their tech guy = no chance for success). Fortunately we did pretty well, but it was pretty risky, even if there was no real chance of losing money.
>>That's according to the preliminary findings of the Congressional Budget Office. Which was an okay source when it was reporting that the old bill would be more expensive.
Sigh...
Because the CBO does a 10 year estimate.
By delaying payouts for four years, but starting taxation earlier, they were able to make it appear like it would save money on an ongoing basis, when they're really just playing accounting tricks worthy of Enron.
>>Here's something funny: if everyone jointly pays for healthcare and everybody gets treated health costs go down.
Nope. The funny thing is that as health care lowers in cost, people go see doctors more often. Your cancer hypothesis aside (and it's probably true), this results in a net increase in health care costs.
>>It's a 4 page bill that basically proposes to extend Medicare benefits to everyone from age 0 to age 64 with a simple 'buy-in.' You buy in at cost and you're covered.
I'm a Libertarian, and I'd actually support this - if it was actually at cost. Given the massive deficits, it appears very likely we'd end up subsidizing anyone "buying in" anyway.
When I did an analysis of Medicare costs, it wasn't actually very cheap at all. Something like $650pp/month.
>>Oh Fox... will you ever be more than a conservative mouthpiece?
Or CNN being a liberal one? I've heard twice today people saying that Tea Partiers are all racists as a result of this story. (Hint: they're not. Nor are they any of the other things the idiot children of MSNBC say they are.)
It's silly to pretend that any of our major media outlets aren't biased. Yahoo news reporting the new bill will save billions of dollars. (Oh, and it will - in the same way that Enron was profitable till the end... accounting malfeasance.)
Not that I'm defending Fox - they're almost as bad as CNN when it comes to bias.
>>Except for the 35-50 million who don't and can't get health insurance.
It's nice to see that people can still parrot talking points, even on Slashdot. That number, bandied about by winners like Pelosi, includes people that don't want health insurance. Our poor people are already covered, as are our elderly, and most working people get it through work. There IS a gap, but it's not as massive as airheads like our majority leaders say it is.
>>But at least over here, if you get hit by a car and left with life-threatening injuries, they treat you first and ask questions later.
I'm not sure why people overseas think it's any different here in the US. If you get hit by a car, you get treated, whether you can pay or not. One of the reasons health care is so expensive is that a lot of people can't afford it, so hospitals jack up the prices on those who can. So it's kind of like socialized medicine already, except screwy. But they don't credit check you when you're missing an arm or something.
>>Finally, the anti-socialist argument that people will sit back and bleed the system dry seems a bit hollow to me in this case.
Why? In your country do people choose to pay more for the same services? I know the drive on the opposite side of the street, but I think most people won't voluntarily choose to pay thousands more for insurance when they don't have to.
>>In the 21st century, it seems barbaric to me that you can have a system where tens of millions of citizens aren't protected in the event of conditions that we can easily treat
Anyone poor automatically gets health coverage through Medicaid. The numbers bandied about by Democrats include people that don't want insurance. When I was in my 20s, I either had no health insurance or some cheap catastrophic insurance and more or less went without for a decade. There's a lot of people like that that appear in these horror stories.
>>there is a woman from the US who has been on some of our TV channels over here, came across as perfectly decent and worked a real job, but couldn't get proper healthcare cover from insurers because of "pre-existing conditions"
Yeah, the whole pre-existing condition thing is real screwy. Our current system sucks if you don't have employer health coverage (the entire industry just doesn't work for you if you're not a corporate wage slave, no matter how much you make). Employer health care generally can't reject coverage to anyone, but it sucks if you're a small business person. This is an area that really needed reform. The fix is probably going to be worse than the cure, though.
>>And IMHO, the socialised system that we all support should pay for much more routine/preventative/advisory care, since in the long term that keeps everyone healthier and avoids paying a greater amount to treat more serious but avoidable conditions later.
Indeed. You won't get any complaints from me for free screenings and such.
I'm with ya, dude. I've spent a long time analyzing the health care industry, just for my own personal edification.
Health care definitely needs reform. As a small business owner myself, I can see how hard it is to get insurance sometimes, even if you're healthy and willing to pay. Our current health care system is designed with the 1950s in mind - people working for large corporations, getting their health care from a group pool. It can be a nightmare for individuals and small business owners.
However, the new system incentivizes everything backwards. It is now optimal for healthy people to go without health insurance, perhaps with just catastrophic coverage, and then sign up when they get sick. Everyone else in your pool will pay for your illness, so people who have traditional insurance will end up paying more. While the current system supports the corporate employee at the expense of the small business owner, the new system reverses the exploitation.
Some notes:
1) About half of all the health care money in the US comes from the government, so the notion about socialized medicine is already half-true. If they opened up Medicare to everyone (paying in at cost so that it doesn't bankrupt the government) that could be an effective replacement for a single-payer system that doesn't destroy the advantages of our current health care system. Or it would, except I think a lot of hospitals are about to start dropping Medicare coverage entirely due to the cuts in the current bill. Medicare reform is desperately needed - it incentivizes doctors in paradoxical ways that are deleterious to patient care.
2) Tort reform is necessary. John Edwards suing doctors because kids randomly get born with Cerebal Palsy does not make doctors better. It makes doctors quit the OB/GYN business, and hurts the general public. The Democrats are a party of lawyers, and the lawyers were the conspicuous winners from this bill. Malpractice insurance makes up a huge part of the cost of health care these days.
3) Medicare Part D needs to be able to negotiate with drug companies for reduced prices. The VA does, which is one of the reasons they can stay afloat on a restricted budget. VA reform is necessary though, too - their computer systems are a babylonian nightmare.
4) The way billing works in hospitals is more or less fraudulent. It works by inflating prices by 4x, offering a 75% discount to insurance companies (who essentially pay the original price), thus screwing over people that don't have insurance in order to cover losses from people that don't pay. You also can't tell how much something is going to cost before you pay for it, if you don't have insurance. When you remove the free market that far from a payer, it's no mistake that the billing system is so messed up.
Ever been to an auto mechanic? They have a list of prices up on the wall - this much for an oil change, this much per hour for labor. We need a rule for hospitals for the same.
How long until Americans figure out that it is much cheaper to pay the fines and pick up health insurance when you need it (now that insurers are required to sign people with preexisting conditions) than to pay premiums year-round?
Or was this the Democrats' intention? Bankrupt the insurance industry and come in as Mr. Government, Savior of All.
Everyone now knows it's a losers game to have insurance. People who have insurance will pay for the people that join in after they get cancer, so it gets more and more unoptimal to have insurance as time goes on and people quit their insurance coverage.
And yeah, with Obama talking about being able to block rate hikes, it's essentially a takeover of the industry if he does it.
Slashdot Mirror
http://lmgtfy.com/?q=obamacare+outlawing+HSAs
>>Err... the insurance companies are not offered a 75% discount. HMO's have protection from government to be profitable
I'm talking about PPOs. HMOs have a totally different cost structure.
>>So your theory is that doctors don't care about compensation
No, what I said was doctors care about healing people. (Well, I said the opposite, but that was sarcasm.)
I'm friends with a number of doctors and pharmacists at the local large regional hospital. Married to one, in fact. The fear of malpractice lawsuits has a huge, and negative, impact on patient care. What is euphemistically called Defensive Medicine means that doctors run tests and procedures they don't need to because trial lawyers have made doctors liable for people getting sick.
Doctors are definitely driven by compensation, as any analysis of medicare billing will reveal. Certain procedures are profitable, certain ones are not (fixed payments at below cost). Guess which procedures get done more? And then tell me this is good for health care with a straight face.
>>That means doctors and hospitals will make 30% less money if malpractice is eliminated.
Uh... yeah. You're completely detached from reality. One of the reasons Kaiser is cost competitive is because you waive your right to sue them for malpractice. In your other post you mention that you have to agree to binding arbitration instead, and having seen that process, let me tell you that you'd never get $100M out of an arbiter because your baby was born a month early. In fact, since Kaiser runs all their business through AAA, I think that they probably have an illegal bias.
The notion that lawsuits improves patient care has been conclusively disproven. Do yourself a favor and start researching the issue yourself.
Yep. The fine (well, tax) is $600/year. You can't get health insurance for that cheap.
Care to lay a bet on it? The CBO estimates can be accurate AND the bill can increase the deficit. If you don't understand why, re-read what I said again.
>>And, since you're so much better than Pelosi, you'll have some official government statistics to back up your claim, right?
Here you go, bub. Start reading: http://www.census.gov/prod/2008pubs/p60-235.pdf
Flip to page 22.
There's 9 million well off people (> $75,000) who don't have health insurance. I'm sure glad they'll have it now under the new plan, aren't you?
Over half without insurance are people under the age of 34. If they're like me, they decided that health insurance wasn't worth it.
>>If there were no malpractice lawsuits, the quality of medical care will definitely be worse
Yes, because doctors certainly don't care about healing people. :p
Guess what - in Kaiser, you can't sue them for malpractice. And you still get Good Enough(tm) care from Kaiser.
In fact, it has been pretty conclusively proven that medical lawsuits harm medical practice rather than helping it. Doctors generally try to do what's best for patients, but when you get into CYA situations a lot of extra tests and surgeries start getting done.
>>So why is per-capita spending on health care higher in the US than anywhere else, but with a lower life expectancy?
Maybe because people in the US make more money than other countries, and we eat like pigs?
They're going to be de facto outlawed, not de jure.
First hit off google:
http://freedomsfreefall.blogspot.com/2010/03/hsas-destroyed-by-obamacare.html
>>I'm guessing that "'Ndrangheta boss" counts for more than "uses facebook" when it comes to calculating an individual's ranking in the criminal respect index.
Yeah, but tweeting your crimes is definitely worth -50 points.
>>But one of the scenes from "Sicko" that really stuck with me was of the man who accidentally cut off a couple of fingertips, and got a choice of which finger they should reattach (he couldn't afford them both).
I watched sicko. You probably shouldn't rely too much on it for factual information. You'd believe that ERs turn away people that can't pay, even though it is against the law for them to do so (and has been for 20 or 30 years now).
I am a small business owner.
Forgiving the debt counts as income, so it doesn't help at all.
But you're right, hospital billing is based on fraud - but on both sides.
>>I don't know how many visits to a GP are needed to outweigh a month in the ICU, but I suspect it's quite a lot.
It's not theory, though. Actual analysis of real numbers shows that costs increase as you make more care available. Make doctors free, and medical costs go through the roof - it's just not the patients paying to see them any more.
>>some brilliant money-making idea that requires $0 start-up you're in for a long ride till your first real profit.
Lol, my family's small business was a brilliant money-making idea that had close to no start-up fees (business license I guess, but that's cheap, and a server). So everything was profit. BUT - you have to consider the value of your time. If I spend all year making $1,000 when I could be making $100,000 as a W2 earner, then the business isn't worth it. And when you're a small business, getting business is the hardest obstacle to overcome. Red tape is annoying, but just getting the word out there that your business exists is really the hardest part.
I made a promise to my mom and dad that I'd give them two years of my life to try to make the company happen (tech company without me their tech guy = no chance for success). Fortunately we did pretty well, but it was pretty risky, even if there was no real chance of losing money.
>>That's according to the preliminary findings of the Congressional Budget Office. Which was an okay source when it was reporting that the old bill would be more expensive.
Sigh...
Because the CBO does a 10 year estimate.
By delaying payouts for four years, but starting taxation earlier, they were able to make it appear like it would save money on an ongoing basis, when they're really just playing accounting tricks worthy of Enron.
>>They have pretty good jobs and have a Health Savings Account that helps them pay those bills
Fortunately, Obamacare is outlawing HSAs.
The long national nightmare of people being able to afford health insurance is finally coming to an end.
>>Here's something funny: if everyone jointly pays for healthcare and everybody gets treated health costs go down.
Nope. The funny thing is that as health care lowers in cost, people go see doctors more often. Your cancer hypothesis aside (and it's probably true), this results in a net increase in health care costs.
Supply and demand is a bitch, ain't it?
>>It's a 4 page bill that basically proposes to extend Medicare benefits to everyone from age 0 to age 64 with a simple 'buy-in.' You buy in at cost and you're covered.
I'm a Libertarian, and I'd actually support this - if it was actually at cost. Given the massive deficits, it appears very likely we'd end up subsidizing anyone "buying in" anyway.
When I did an analysis of Medicare costs, it wasn't actually very cheap at all. Something like $650pp/month.
>>Oh Fox... will you ever be more than a conservative mouthpiece?
Or CNN being a liberal one? I've heard twice today people saying that Tea Partiers are all racists as a result of this story. (Hint: they're not. Nor are they any of the other things the idiot children of MSNBC say they are.)
It's silly to pretend that any of our major media outlets aren't biased. Yahoo news reporting the new bill will save billions of dollars. (Oh, and it will - in the same way that Enron was profitable till the end... accounting malfeasance.)
Not that I'm defending Fox - they're almost as bad as CNN when it comes to bias.
Mod parent up. He captured the entire issue in a nutshell.
The current bill will probably bankrupt the insurance industry, thus paving the way for socialized medicine.
>>Except for the 35-50 million who don't and can't get health insurance.
It's nice to see that people can still parrot talking points, even on Slashdot. That number, bandied about by winners like Pelosi, includes people that don't want health insurance. Our poor people are already covered, as are our elderly, and most working people get it through work. There IS a gap, but it's not as massive as airheads like our majority leaders say it is.
>>But at least over here, if you get hit by a car and left with life-threatening injuries, they treat you first and ask questions later.
I'm not sure why people overseas think it's any different here in the US. If you get hit by a car, you get treated, whether you can pay or not. One of the reasons health care is so expensive is that a lot of people can't afford it, so hospitals jack up the prices on those who can. So it's kind of like socialized medicine already, except screwy. But they don't credit check you when you're missing an arm or something.
>>Finally, the anti-socialist argument that people will sit back and bleed the system dry seems a bit hollow to me in this case.
Why? In your country do people choose to pay more for the same services? I know the drive on the opposite side of the street, but I think most people won't voluntarily choose to pay thousands more for insurance when they don't have to.
>>In the 21st century, it seems barbaric to me that you can have a system where tens of millions of citizens aren't protected in the event of conditions that we can easily treat
Anyone poor automatically gets health coverage through Medicaid. The numbers bandied about by Democrats include people that don't want insurance. When I was in my 20s, I either had no health insurance or some cheap catastrophic insurance and more or less went without for a decade. There's a lot of people like that that appear in these horror stories.
>>there is a woman from the US who has been on some of our TV channels over here, came across as perfectly decent and worked a real job, but couldn't get proper healthcare cover from insurers because of "pre-existing conditions"
Yeah, the whole pre-existing condition thing is real screwy. Our current system sucks if you don't have employer health coverage (the entire industry just doesn't work for you if you're not a corporate wage slave, no matter how much you make). Employer health care generally can't reject coverage to anyone, but it sucks if you're a small business person. This is an area that really needed reform. The fix is probably going to be worse than the cure, though.
>>And IMHO, the socialised system that we all support should pay for much more routine/preventative/advisory care, since in the long term that keeps everyone healthier and avoids paying a greater amount to treat more serious but avoidable conditions later.
Indeed. You won't get any complaints from me for free screenings and such.
I'm with ya, dude. I've spent a long time analyzing the health care industry, just for my own personal edification.
Health care definitely needs reform. As a small business owner myself, I can see how hard it is to get insurance sometimes, even if you're healthy and willing to pay. Our current health care system is designed with the 1950s in mind - people working for large corporations, getting their health care from a group pool. It can be a nightmare for individuals and small business owners.
However, the new system incentivizes everything backwards. It is now optimal for healthy people to go without health insurance, perhaps with just catastrophic coverage, and then sign up when they get sick. Everyone else in your pool will pay for your illness, so people who have traditional insurance will end up paying more. While the current system supports the corporate employee at the expense of the small business owner, the new system reverses the exploitation.
Some notes:
1) About half of all the health care money in the US comes from the government, so the notion about socialized medicine is already half-true. If they opened up Medicare to everyone (paying in at cost so that it doesn't bankrupt the government) that could be an effective replacement for a single-payer system that doesn't destroy the advantages of our current health care system. Or it would, except I think a lot of hospitals are about to start dropping Medicare coverage entirely due to the cuts in the current bill. Medicare reform is desperately needed - it incentivizes doctors in paradoxical ways that are deleterious to patient care.
2) Tort reform is necessary. John Edwards suing doctors because kids randomly get born with Cerebal Palsy does not make doctors better. It makes doctors quit the OB/GYN business, and hurts the general public. The Democrats are a party of lawyers, and the lawyers were the conspicuous winners from this bill. Malpractice insurance makes up a huge part of the cost of health care these days.
3) Medicare Part D needs to be able to negotiate with drug companies for reduced prices. The VA does, which is one of the reasons they can stay afloat on a restricted budget. VA reform is necessary though, too - their computer systems are a babylonian nightmare.
4) The way billing works in hospitals is more or less fraudulent. It works by inflating prices by 4x, offering a 75% discount to insurance companies (who essentially pay the original price), thus screwing over people that don't have insurance in order to cover losses from people that don't pay. You also can't tell how much something is going to cost before you pay for it, if you don't have insurance. When you remove the free market that far from a payer, it's no mistake that the billing system is so messed up.
Ever been to an auto mechanic? They have a list of prices up on the wall - this much for an oil change, this much per hour for labor. We need a rule for hospitals for the same.
Everyone now knows it's a losers game to have insurance. People who have insurance will pay for the people that join in after they get cancer, so it gets more and more unoptimal to have insurance as time goes on and people quit their insurance coverage.
And yeah, with Obama talking about being able to block rate hikes, it's essentially a takeover of the industry if he does it.
>>Watch and learn. Mandated "you must buy X" means that the cost of X will go up, not down.
Yeah, people used to understand things related to supply and demand, but now we just wave magical fairy wands and get whatever we want.