Price - Three Hours in the Emergency Room

ColoradoGuy · Aug 10, 2009

Robert Toy said:
I don't understand either.

But then again I don't undersatnd why everyone loves Palin punching either.

Because there's still candy in the pinata. Plus, I think the Swift Boat episode taught us it is a bad idea to ignore loony assertions that get media play.

dclary · Aug 10, 2009

ColoradoGuy said:
How would that happen? I mean, some people keep saying it, but I can't understand why they do.

Currently, we live in a mostly free market health care system. This allows medical practitioners to earn a market-established price for their services. This allows for wiggle room where people can negotiate better prices for their services.

The Obama plan is the eventual complete regulation of the entire industry. Which means if you can't get the government to allow you a procedure, you probably won't ever be able to get it, because you will not be able to haggle your medical practitioner down from the state-mandated price.

blacbird · Aug 10, 2009

ColoradoGuy said:
Because there's still candy in the pinata.

Candy with pins and razor blades in it.

caw

Siddow · Aug 10, 2009

I have a gripe.

At our county health department, you can get an immunization for chicken pox for $15. Which is $25 less than my co-pay to go to the regular doctor, where the shot would be paid in full by the insurance company.

BUT...walk into the health department as an INSURED individual wanting that shot, and the price goes up to $175.

I'm trying to figure out how that makes sense.

ColoradoGuy · Aug 10, 2009

dclary said:
Currently, we live in a mostly free market health care system. This allows medical practitioners to earn a market-established price for their services. This allows for wiggle room where people can negotiate better prices for their services.

The Obama plan is the eventual complete regulation of the entire industry. Which means if you can't get the government to allow you a procedure, you probably won't ever be able to get it, because you will not be able to haggle your medical practitioner down from the state-mandated price.

The Obama plan does not eliminate private insurance, and, the way things are looking, it may not even have a public option. So that will actually be a potential windfall for the insurance industry because it will force people to buy policies (this is my major issue -- I want a public option). There is nothing in there about state-mandated prices for private plans. There is also nothing in there that aims to eliminate the private practice of medicine.

Medicare and Medicaid already account for over half of healthcare spending (and fit some people's definition of "socialized" medicine), and these already have fixed fees -- no negotiation is possible. We don't really live in a free market medical system today.

Robert Toy · Aug 10, 2009

Siddow said:
I have a gripe.

At our county health department, you can get an immunization for chicken pox for $15. Which is $25 less than my co-pay to go to the regular doctor, where the shot would be paid in full by the insurance company.

BUT...walk into the health department as an INSURED individual wanting that shot, and the price goes up to $175.

I'm trying to figure out how that makes sense.

to make up for the discounted $15 shots?

Robert Toy · Aug 10, 2009

ColoradoGuy said:
The Obama plan does not eliminate private insurance, and, the way things are looking, it may not even have a public option. So that will actually be a potential windfall for the insurance industry because it will force people to buy policies (this is my major issue -- I want a public option). There is nothing in there about state-mandated prices for private plans. There is also nothing in there that aims to eliminate the private practice of medicine.

Medicare and Medicaid already account for over half of healthcare spending (and fit some people's definition of "socialized" medicine), and these already have fixed fees -- no negotiation is possible. We don't really live in a free market medical system today.

Re: public option - There are a few things the government can do to prevent an insurance industry take over (the left side of the rumors), just a few
- cap the premiums
- Medical lawsuit caps
- Open inter-state insurance coverage

currently they are only looking at one, which is bad for the insurance company, hence their resistance. Who wants to be driven out of business?

ColoradoGuy · Aug 10, 2009

Robert Toy said:
Re: public option - There are a few things the government can do to prevent an insurance industry take over (the left side of the rumors), just a few
- cap the premiums
- Medical lawsuit caps
- Open inter-state insurance coverage

currently they are only looking at one, which is bad for the insurance company, hence their resistance. Who wants to be driven out of business?

#2 and #3 sound reasonable, but why cap premiums in the private plans? Isn't the idea to let insurance companies compete?

Regarding malpractice caps. The odd thing about malpractice is that the statistics show that it accounts for a tiny fraction of costs, but nearly all doctors (including me) have the perception that defensive medicine is a real cost-driver. I think more important than capping payouts is figuring out a better way than the tort system to compensate injured patients and punish negligent doctors. The malpractice system does a very poor job at doing both of those, the two important things it should accomplish.

Robert Toy · Aug 10, 2009

ColoradoGuy said:
#2 and #3 sound reasonable, but why cap premiums in the private plans? Isn't the idea to let insurance companies compete?

Regarding malpractice caps. The odd thing about malpractice is that the statistics show that it accounts for a tiny fraction of costs, but nearly all doctors (including me) have the perception that defensive medicine is a real cost-driver. I think more important than capping payouts is figuring out a better way than the tort system to compensate injured patients and punish negligent doctors. The malpractice system does a very poor job at doing both of those, the two important things it should accomplish.

Capping premiums I believe is part of the draft bills, IMHO it is meant to please the screaming masses...it's all the greedy insurance industry's fault.

if you can do both, cap premiums and give the insurance industry a larger market it may work out as a win-win.

rugcat · Aug 10, 2009

ColoradoGuy said:
I think more important than capping payouts is figuring out a better way than the tort system to compensate injured patients and punish negligent doctors. The malpractice system does a very poor job at doing both of those, the two important things it should accomplish.

Charles Krauthammer has an interesting idea about this. In part:

"What to do? Abolish the entire medical-malpractice system. Create a new social pool from which people injured in medical errors or accidents can draw. The adjudication would be done by medical experts..."

http://townhall.com/columnists/CharlesKrauthammer/2009/08/07/health_care_reform_a_better_plan

Of course, he also still thinks the Iraq war was a great idea, but his proposal is worth considering.

Don · Aug 10, 2009

Robert Toy said:
I don't understand either.

But then again I don't undersatnd why everyone loves Palin punching either.

With that avatar, how can you claim not to understand the joy of tilting at windmills?

ColoradoGuy · Aug 10, 2009

rugcat said:
Charles Krauthammer has an interesting idea about this. In part:

"What to do? Abolish the entire medical-malpractice system. Create a new social pool from which people injured in medical errors or accidents can draw. The adjudication would be done by medical experts..."

http://townhall.com/columnists/CharlesKrauthammer/2009/08/07/health_care_reform_a_better_plan

Of course, he also still thinks the Iraq war was a great idea, but his proposal is worth considering.

Many advocate such a no-fault system. It could work if there was a way to make sure physicians who need disciplining get disciplined. You would also need to have a broad-based panel, not just docs. Interesting that he is willing to compensate people who have simply a poor outcome, even if no one is at fault. Sounds pretty socialist for Krauthammer.

Robert Toy · Aug 10, 2009

Don said:
With that avatar, how can you claim not to understand the joy of tilting at windmills?

there are windmills and then there are concrete dams, watash knows the difference.

Gretad08 · Aug 10, 2009

ColoradoGuy said:
The Obama plan does not eliminate private insurance, and, the way things are looking, it may not even have a public option. So that will actually be a potential windfall for the insurance industry because it will force people to buy policies (this is my major issue -- I want a public option). There is nothing in there about state-mandated prices for private plans. There is also nothing in there that aims to eliminate the private practice of medicine.

Medicare and Medicaid already account for over half of healthcare spending (and fit some people's definition of "socialized" medicine), and these already have fixed fees -- no negotiation is possible. We don't really live in a free market medical system today.

From what I've heard, (I don't know for sure, b/c I haven't read the bill)the plan will allow you to keep your private insurance UNTIL you change jobs...the insurance companies won't take on new clients but they will maintain their existing.

Like I said, don't know for sure...if someone could shed some light on this that would be great.

Dommo · Aug 10, 2009

How about health insurance is premiums are capped at exactly 5% of your yearly income. That way everybody pays, and insurance might actually be affordable. But more than anything we need the medical industry to be non-profit. When there's life an death on the line, the last thing that should matter is the bottom line.

Siddow · Aug 10, 2009

Robert Toy said:
to make up for the discounted $15 shots?

but...but...the insurance company only pays that! It does really boggle the mind with Why Bothers??? when I have the choice to pay the ins co $500 a month and the doctor a $40 co-pay for something I could get for $15 if I dropped my insurance.

Mind you, it's not a need-based thing to get the shot at the health department. Anyone can. It's just gonna cost more if you are insured, or at least, if you say you are insured.

You can still LIE and get it cheaper. It's the honest people who get screwed. Dang.

rugcat · Aug 10, 2009

Siddow said:
but...but...the insurance company only pays that! It does really boggle the mind with Why Bothers??? when I have the choice to pay the ins co $500 a month and the doctor a $40 co-pay for something I could get for $15 if I dropped my insurance.

That's why I get my flu shots at the Walgreens drugstore and just pay for them.

Don · Aug 11, 2009

OMG, rc, you use the free market when there's a whole medical/insurance bureaucracy out there to take advantage of?

rugcat · Aug 11, 2009

Don said:
OMG, rc, you use the free market when there's a whole medical/insurance bureaucracy out there to take advantage of?

Actually, the shots are offered at cost not by Walgreens but by outreach non profit medical agencies. They even take Medicare.

Walgreens provides the venue, which gets people into the stores and sets in their minds that it's a good place to come for their prescription needs -- a smart business model. I'm even willing to concede they might want to do some good for the community.

But yeah, I love the free market. I just don't consider it a religious institution.

Mr Flibble · Aug 11, 2009

And the moral of this story is...

If you're going to fall off a ladder, do it somewhere where the health service is free.

Robert Toy · Aug 11, 2009

IdiotsRUs said:
And the moral of this story is...

If you're going to fall off a ladder, do it somewhere where the health service is free.

Whew, tough crowd

archerjoe · Aug 11, 2009

From about 7 years ago, just having a kid in the NICU cost about $10,000 per week. Not including any doctors, procedures, specialists, etc.

Price - Three Hours in the Emergency Room

I've seen worse.

Unabashed Mercenary

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Lost in the Fog

All Living is Local

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On Mac's double secret probation.

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They've been very bad, Mr Flibble

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