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 Post subject: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 12:41 pm  
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Querulous Quidnunc
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http://healthland.time.com/2013/02/20/b ... illing-us/

Quote:
"When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?"



Hiding under the guise of "non profit" organizations, the fastest growing and largest companies are often healthcare systems in the US.

Execs are routinely paid in excess of $1 million.

Americans spend about 20% of total GDP on healthcare...that's nearly 10% higher than everyone else.


Holy shit.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 4:08 pm  
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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 5:13 pm  
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Querulous Quidnunc
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The article is 100% bullshit. It's a paid editorial by the insurance companies.

The point of the article is to convey blame from where it belongs (insurance companies and HMOs) and put it on the backs of physicians and primary care providers. It does this by trying to argue that the way Canada keeps healthcare costs down is by regulating physicians and not insurance companies (funny argument for a country with a STATE-RUN healthcare system).

The article also tries to argue that insurance companies and individuals have similar interests against doctors when in reality the truth is the opposite. Physicians exist to deliver care, insurance companies exist to keep people from care. Every penny a physician gets for delivering primary care is a penny the insurance company doesn't get, and every penny an insurance company gets is a penny that doesn't wind up in the hands of a primary care provider. And if you think that "savings get passed onto the consumer" you are fucking retarded. (Like, not just retarded, fucking retarded)

Insurance companies have a vested interest in expensive and ineffective care, because primary care (i.e., doctors spending 12 hours a day telling people to go "ahh", prescribing antibiotics, doing physicals, treating common diseases and wounds, administering vaccinations) is WAY less profitable for big business than selling radiology hardware and exotic prescriptions. The same few investors that own the big insurance companies are the same ones that write the policies favoring ineffective, hardware-intensive approaches.

And I'd ask you, Azelma - why you didn't clearly see the article's bias? You're reading TIME magazine. Do you seriously think it's going to be anything other than corporate propaganda? You might as well be reading Pravada. Why do you even read that crap, seriously? Why do you think for a moment that it's going to be anything but lies? How can you be so gullible? Seriously, man.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 5:34 pm  
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Querulous Quidnunc
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Can't it be both?

Can't it be the insurance companies being assholes...and isn't it possible that hospitals etc in america are charging too much?


Also, do you think it's okay that healthcare executives are paid so handsomely? We're talking millions and millions of dollars?

These "non profit" organizations make money far beyond the actual costs of medicine and care. This seems right to you?



The article is not perfect...and yes, clearly has an agenda. I'm just saying....why not attack both sides...it points out one good thing about Medicare is the accountability...

Do you not think accountability is important? If aspirin only costs $1....why charge $10?


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 5:42 pm  
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Other countries have state-run systems.
They remove insurance companies as a force within the system.
Their costs are low and their service is good.
Therefore, insurance companies are the problem.

It is not "both". You're splitting the difference because you don't like the cold, hard facts.

Just because something is a non-profit doesn't mean it's a charity. "Non-profit" is a tax designation, and it is - here it comes - the corporations and big business that don't want our porous business tax code cleaned up. The other thing they don't want is to fully fund Medicare, public clinics and universities, so instead the big money moves in and controls those systems.

If public clinics were fully funded, and Medicare was universal, the problems the article describes would not exist; everyone would get the same reasonably low rates, just like in every other Western country. Then again, if that were the case - public clinics were fully funded, universal Medicare - insurance companies and their hangers-on wouldn't be able to make a profit.

So who do you think doesn't want the situation to change? You tell me.

(a window into why the US has a per capita GDP higher than even Germany but a standard of living worse than almost any country in Europe: most of the US's GDP is inefficiency and sheer bloat)

The question remains. Why are you reading this crap? Why do you take it seriously? The article is propaganda. Any truth is incidental. You wouldn't read Pravada or whatever they print in North Korea and think it's anything but nonsense, so why read this and think there might be some truth to it?

(also a window into the minds of North Koreans and why political change there is a pipe dream - they see the propaganda about the Kims and think exactly what Azelma is thinking, which is that it can't possibly be entirely horseshit)

EDIT: I edited that like 20 times, I'm done editing now =P


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 8:17 pm  
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It's really a number of interwoven things. A lot of it is the hospital administration (NOT the physicians, nurses, etc) and insurance companies.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 9:01 pm  
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health care is its own economy.

equipment, medicine, treatments, services, pay for employees, utilities/taxes for the hospitals/clinics themselves.

Also the things that cost money but don't show a return, such as uninsured emergency room care.

then there's the other stuff like R&D, supply and demand, etc.

I honestly couldn't even begin to list all of the factors involved with the cost of care, but there's a fuck-ton of them.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Sun Feb 24, 2013 11:33 pm  
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Usdk wrote:
Also the things that cost money but don't show a return, such as uninsured emergency room care.
.

Why should the life and death of your countrymen be a for-profit venture?


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 12:23 am  
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Querulous Quidnunc
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I'm just saying it costs money to save lives. Hospitals will make the cost up somewhere.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 12:52 am  
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Aestu wrote:
Other countries have state-run systems.
They remove insurance companies as a force within the system.
Their costs are low and their service is good.
Therefore, insurance companies are the problem.

It is not "both". You're splitting the difference because you don't like the cold, hard facts.

Just because something is a non-profit doesn't mean it's a charity. "Non-profit" is a tax designation, and it is - here it comes - the corporations and big business that don't want our porous business tax code cleaned up. The other thing they don't want is to fully fund Medicare, public clinics and universities, so instead the big money moves in and controls those systems.

If public clinics were fully funded, and Medicare was universal, the problems the article describes would not exist; everyone would get the same reasonably low rates, just like in every other Western country. Then again, if that were the case - public clinics were fully funded, universal Medicare - insurance companies and their hangers-on wouldn't be able to make a profit.

So who do you think doesn't want the situation to change? You tell me.

(a window into why the US has a per capita GDP higher than even Germany but a standard of living worse than almost any country in Europe: most of the US's GDP is inefficiency and sheer bloat)

The question remains. Why are you reading this crap? Why do you take it seriously? The article is propaganda. Any truth is incidental. You wouldn't read Pravada or whatever they print in North Korea and think it's anything but nonsense, so why read this and think there might be some truth to it?

(also a window into the minds of North Koreans and why political change there is a pipe dream - they see the propaganda about the Kims and think exactly what Azelma is thinking, which is that it can't possibly be entirely horseshit)

EDIT: I edited that like 20 times, I'm done editing now =P



I guess I don't understand why you're all up in arms...did you even read the article?

Quote:
If public clinics were fully funded, and Medicare was universal, the problems the article describes would not exist; everyone would get the same reasonably low rates, just like in every other Western country


I don't think you read it...if you had read it, you would see that the article speaks very highly of Medicare. It praises the accountability that medicare encourages by making sure hospitals can only charge what things actually cost. It points out how much cheaper healthcare is in other countries.....countries with public health options, how does that make them insurance propaganda writers? Wouldn't insurance propaganda articles not want to evangelize government-sponsered healthcare systems?


The article goes on to point out that one of the issues is hospitals charge so much to non-medicare patients. Those with private insurance (well, good private insurance) are okay, but those with no health insurance to speak of (and too young for medicare) are screwed.



I think you read a few paragraphs and decided the article was simply bashing hospitals and absolving insurance companies of all blame. It wasn't. The fact that it portrayed Medicare in such a positive light is proof of this.

Does it focus on only one symptom of the problem? Yes. Do hospitals charge outrageous rates because they can, yes. Are insurance companies the largest offender in the American healthcare shitstorm? Yes.

This article merely tried to ask a question, "why is healthcare in America so much more expensive?"

You didn't respond to my questions about executive compensation in healthcare systems. Executives who are not doctors or medical professionals in any sense...merely businessmen making profit off of health. This article takes great strides to point out the evils of this. And it should.



Again, I don't think you read it...if you did, you would see that it's pointing out much of what you say...Medicare gets things cheaper because of accountability. Private insurance allows hospitals to charge whatever the heck they want...it's two leeches sucking on the same cash flow (insurance companies and hospitals that overcharge).


Please provide specific citations in the article where it shows clearly that they are promoting Insurance companies and absolving them of all blame in our broken healthcare system.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 2:38 am  
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Mns wrote:
Why should the life and death of your countrymen be a for-profit venture?


Even the "not for profit" medical facilities were "gouging" on their mark-up for good and services. "Profit" isn't the problem.

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 Post subject: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 6:24 am  
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Profit is the problem with just about every aspect of our modern world.


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 7:33 am  
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Azelma wrote:
Please provide specific citations in the article where it shows clearly that they are promoting Insurance companies and absolving them of all blame in our broken healthcare system.


Quote:
Recchi’s bill and six others examined line by line for this article offer a closeup window into what happens when powerless buyers — whether they are people like Recchi or big health-insurance companies — meet sellers in what is the ultimate seller’s market.


Quote:
The health care industry seems to have the will and the means to keep it that way. According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington.


Quote:
The other $2 trillion will be paid mostly by private health-insurance companies and individuals who have no insurance or who will pay some portion of the bills covered by their insurance. This is what’s increasingly burdening businesses that pay for their employees’ health insurance and forcing individuals to pay so much in out-of-pocket expenses.


Quote:
Stamford Hospital’s chargemaster assigns prices to everything, including Janice S.’s blood tests. It would seem to be an important document. However, I quickly found that although every hospital has a chargemaster, officials treat it as if it were an eccentric uncle living in the attic. Whenever I asked, they deflected all conversation away from it. They even argued that it is irrelevant.


Quote:
As we examine other bills, we’ll see that like Medicare patients, the large portion of hospital patients who have private health insurance also get discounts off the listed chargemaster figures, assuming the hospital and insurance company have negotiated to include the hospital in the insurer’s network of providers that its customers can use. The insurance discounts are not nearly as steep as the Medicare markdowns, which means that even the discounted insurance-company rates fuel profits at these officially nonprofit hospitals.


Quote:
Also on the bill were items that neither Medicare nor any insurance company would pay anything at all for: basic instruments and bandages and even the tubing for an IV setup.


Quote:
Steve H. was about to run up against a seemingly irrelevant footnote in millions of Americans’ insurance policies: the limit, sometimes annual or sometimes over a lifetime, on what the insurer has to pay out for a patient’s claims. Under Obamacare, those limits will not be allowed in most health-insurance policies after 2013.


I could go on like this but the point is made.

Every time the insurance companies are mentioned, it is in a favorable context. The reason the article associates them with Medicare and foreign systems that are known to work is because it wants to project that same positive aura on them.

The article also excludes insurance industries from lists of bad guys where they would normally belong, and argues that Obamacare (which reined in their worst abuses, including the limit clause, which was never about anything but denying care, and has no place in Medicare or other Western state healthcare systems, is bad).

The article didn't "try" to "ask a question". The article, like absolutely everything else in TIME, is blatant propaganda and you should feel bad for allowing yourself to be manipulated by it so easily.

Further proof the article is propaganda. It pulls the whole "death panel" routine and tries to demonize the innocuous. CHARGEMASTERS OMG. Spends three pages talking about them. The chargemaster says what procedures cost at any given hospital. Well if there wasn't a chargemaster, then how would the cost be defined? Durp. Every firm in every industry has someone responsible for setting prices. Demonizing the innocuous and trying to make nothing itself look suspicious is characteristic of all propaganda. The article adopts the same style as Tea Party talk about "death panels" because its true loyalty is the same.

Jubbergun wrote:
Even the "not for profit" medical facilities were "gouging" on their mark-up for good and services. "Profit" isn't the problem.


We know for a fact this is untrue.

State-care systems, in which profit is not as strong a driving force as it is within the American system, do not have these problems. "Non-profit" is merely a tax designation and does not accurately characterize the forces operating in our system, by design.

Quote:
I don't think you read it...if you had read it, you would see that the article speaks very highly of Medicare. It praises the accountability that medicare encourages by making sure hospitals can only charge what things actually cost. It points out how much cheaper healthcare is in other countries.....countries with public health options, how does that make them insurance propaganda writers? Wouldn't insurance propaganda articles not want to evangelize government-sponsered healthcare systems?


The goal of the article is to make insurance companies look indispensable and conceal the fact (as it has so brilliantly done so with you) that the insurance companies themselves are what separate our system from theirs. It does this by way of directly associating those insurance companies with the systems to which they are antithetical.

If it were not so, why would the article do that, when doing so is totally illogical and contrary-to-fact?
Why does it try to demonize "chargemasters" when doing so doesn't make sense either?

And you still haven't answered my question - again - why take this crap any more seriously than any other propaganda? Do we say that Pravda or Xinghua or any other propaganda rag is just "making an argument"? Or do we completely write it off because we know that truth is incidental?


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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 1:42 pm  
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Battletard wrote:
Profit is the problem with just about every aspect of our modern world.


Profit has its place, and is the primary motivator for economic activity of any type. It's only a problem when it is focused upon to the exclusion of all other priorities.

Aestu is right, to an extent, about the article being a PR piece for the insurance industry...the same insurance industry that stepped out of the way for Obamacare when President Obama and his party threw them the bone of "everyone must buy your product." Hooray for increased revenue and more crony-capitalism. Now that we all have to buy our tea from the East India Company you' should become accustomed to more friendly propaganda in the friendly media for the "friends" of the powers-that-be.

Oh, and the reason everyone is focusing on "who is paying," Azelma, is that who pays changes the incentives and disincentives to seek and/or provide service. Go to a local ER at night and talk to the people there and you will see some of the perverse incentives the current system of compensation encourages. The night I went in after having hot fryer grease dumped on my arm I waited for hours, and I met two couples who had brought their children in for basic flu-like symptoms. The one guy was unemployed and his kid was on some form of government medical aid, and he said the only reason they came into the ER late at night was because they wouldn't have to pay any co-pays under the system that cared for their child, but if they made an appointment with a doctor the next day they'd have to pay a $25 co-pay. They were taking up space in the ER because the subsidies in the system they were a part of encouraged them to do so.

The article you linked also fails to mention why those products are marked up for "gouging." All the 'free' care hospitals are, by law, obligated to provide--they can't turn you away in an ER without treating you, especially if the hospital receives federal funds, but they can make you wait forever--and the real costs of medicare/medicaid treatment has to be paid by someone, and hospitals make up their losses on charity and participation in government programs by gouging the insurance companies that can afford to pay.

The best thing they could do to fix the system is to have every provider determine the cost of every service/treatment they provide and register their pricing at fixed intervals, then make every payer, from the individual to the government to insurance companies, pay those fees. It would not only equalize costs across different payer types, it would also reveal to the taxpayer the true cost of the various healthcare support systems the government funds.

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 Post subject: Re: Reason #2386862 to move to Canada
PostPosted: Mon Feb 25, 2013 1:56 pm  
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Jubbergun wrote:
Aestu is right, to an extent, about the article being a PR piece for the insurance industry...the same insurance industry that stepped out of the way for Obamacare when President Obama and his party threw them the bone of "everyone must buy your product." Hooray for increased revenue and more crony-capitalism. Now that we all have to buy our tea from the East India Company you' should become accustomed to more friendly propaganda in the friendly media for the "friends" of the powers-that-be.


This I would agree with. I thought it was outrageous as well. And it does show who the real villains here are.

Jubbergun wrote:
The best thing they could do to fix the system is to have every provider determine the cost of every service/treatment they provide and register their pricing at fixed intervals, then make every payer, from the individual to the government to insurance companies, pay those fees.


What you are describing is the ultimate seller's market.
The sellers have a cartel, name their price, everyone has to pay it - or else.

You're treating the players - all of them - as monolithic. How do you fix and negotiate prices market-wide without government institutions and regulation establishing a modus operandi?


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