The Tyranny of Medical Bills in America

[Petrus]

Case study (me):

Left hip replacement surgery: 3 visits to doctor, X-rays, pre-operation consultations, 3 visits to dentist, surgery with 2 nights in the hospital, removal of stitches 2 weeks after (actually steel staples). Total cost to me: 270 €. They also compensated me the cost of driving to to hospital & taxi home.

Happy taxpayer.

And all 3 kids are going through the best universities. Cost: government is paying them 500€ a month…
 
Happy to live here...

[Rob C]

Case study (me):

Left hip replacement surgery: 3 visits to doctor, X-rays, pre-operation consultations, 3 visits to dentist, surgery with 2 nights in the hospital, removal of stitches 2 weeks after (actually steel staples). Total cost to me: 270 €. They also compensated me the cost of driving to to hospital & taxi home.

Happy taxpayer.

And all 3 kids are going through the best universities. Cost: government is paying them 500€ a month…
 
Happy to live here...

Lucky you!

In Mallorca, which I presume is still within Spain - but you never know, what with local separatists - dentistry forms no part of the National Health system. You pay (personally) for it all.

My wife and I used to go to a very good Argentinian dentist in Alcudia, a neighbouring town, and I discovered he was an avid photographer too. Regardless of who was in the chair, mouth wide open, it was cameras and PS for the duration, the difference being that when I was seated, all I could contribute was a choke and a nervous nod. Anyway it was basically through him and his little digi-with-Zeiss that I saw my first digital print. I was knocked out by the colours and the crispness!

Anyway, he shared the clinic with his wife; they split, and he moved away to Gerona, on the mainland. I don't think he had an interest in hunting.

But, back to topic: I went to see the folks who'd taken over the practice and asked for an inspection, which I got, with the news that I requird three fillings. That surprised me, because I'd been doing regular six-monthy checks. Away, I got my first appointment and it turned out to be with a different dentist than the one who'd checked me out. This one tut-tutted a lot, then asked me what I needed done. That surprised me. Anyway, figuring that each filling comes in at a fairly standard €50 a pop, I reckoned that the pension could afford that, so I lay back and let the mother have his way. In the end, and several sessions later, the entire connection ended after I had run up a bill for €450. Three fillings had magically turned into nine! I swear on whatever you hold holy that this is the unadorned truth.

To me, it explains a lot about the  buying and recreational habits of some of our fellow persons.

Rob C

[Isaac]

… so the public will pay more for their health care then they would have before the law.

Health insurance premiums more than doubled in the decade before the law.

Again, the question is -- Do consumers accept that healthcare provision is not a monopoly just because industry lobbyists say so again and again?

Whether healthcare is provided by for-profit corporations, non-profits or governments; without price transparency, or a reasonable expectation that consumers are in any position to price-shop while their life is at risk, healthcare provision is effectively a monopoly.

Whether healthcare is provided by for-profit corporations, non-profits or governments; a monopoly requires external regulators to promote quality and limit costs.

Can you imagine a law that required everyone to buy a camera?

"Financial Responsibility (Insurance) Requirements for Vehicle Registration"

[RSL]

Case study (me):

Left hip replacement surgery: 3 visits to doctor, X-rays, pre-operation consultations, 3 visits to dentist, surgery with 2 nights in the hospital, removal of stitches 2 weeks after (actually steel staples). Total cost to me: 270 €. They also compensated me the cost of driving to to hospital & taxi home.

Happy taxpayer.

And all 3 kids are going through the best universities. Cost: government is paying them 500€ a month…
 
Happy to live here...

That would be wonderful, Petrus, if "the government" actually had any money. What you're telling us is that the TAXPAYERS are paying them 500 a month. That's great if you want the government to decide how you should spend your money. Frankly, I'd prefer to make that decision myself.

[Slobodan Blagojevic]

As much as the American health system leaves much to be desired, and as much we might admire (or not) Canadian, Australian, Finnish, etc. socialized ones, one thing remains: social, political and economic systems can not be easily Frankenstein-ized, i.e., built by patching pieces, best of multiple worlds, into one.

[Isaac]

Life! Who said it would be easy?

[Petrus]

That would be wonderful, Petrus, if "the government" actually had any money. What you're telling us is that the TAXPAYERS are paying them 500 a month. That's great if you want the government to decide how you should spend your money. Frankly, I'd prefer to make that decision myself.

Taxpayers* have all together decided that giving free education to all who want it and are capable of receiving it, and paying them about 500€ a month in the form of rent and meal subsidies and also clean cash to make full time studying possible, is a good investment for future and equality in the society.

*) cabin, parliament and the elected president, who propose, pass and sing the laws. They all represent taxpayers.

[amolitor]

There are certain services which we generally agree the government is best suited to administer. Things like law enforcement, fire departments, defense.

There are other services which we generally agree governments are not well suited to administer, the distribution of food, say.

The USA seems to be split as a nation on the question of where medical care fits. We're deeply unsatisfied with the private enterprise solution, but suspicious of a government provided solution. Other nations seem to find that their governments do a good job. They seem quite satisfied with the distribution mechanisms for medical care.

None of this has to do with "who pays" because the answer is in all cases "us".

[RSL]

Taxpayers* have all together decided that giving free education to all who want it and are capable of receiving it, and paying them about 500€ a month in the form of rent and meal subsidies and also clean cash to make full time studying possible, is a good investment for future and equality in the society.

*) cabin, parliament and the elected president, who propose, pass and sing the laws. They all represent taxpayers.

Exactly what I said. You have a group of people who'd rather turn over their money and their financial decisions to elected "experts." They don't feel competent to make adequate economic decisions themselves, and since that's the case they're probably right. When that's what you want, that's what you get. I'm not knocking it, but it's not what I want or what most people in the U.S. used to want. As far as subsidizing rent and meals plus handing cash to students, whether or not it's a good investment for the future is questionable. I notice that there are very few IBM's, Apples, Googles, etc., that come into existence in countries that do that. You might wonder why that's so. As far as "equality" is concerned, I'd point you toward Thomas Sowell's Wealth, Poverty and Politics: An International Perspective. It's pretty enlightening stuff.

[Ray]

For those of us who are still in good health, this thread could be a useful warning and reminder of what's in store for us if we don't take responsibility for our own health.

It's no secret that the basis for good health and longevity is a lifestyle which includes regular exercise and a wholesome diet. Anyone who isn't eating an ideal, natural and wholsesome diet and who doesn't take regular walks, or some form of regular exercise (in addition to climbing in and out bed, in and out of his car, and walking from the kitchen to the lounge etc),  is definitely increasing his risk of incurring huge medical bills in the future. Who pays those bills is another matter.

Most people seem to be in a state of denial about this issue of what constitutes a healthy lifestyle. Almost 3/4ths of all Americans are overweight. About 1/3rd of all Americans fall into the category of being obese. Is it any wonder that America also has inflated medical and pharmaceutical industries?

[Rob C]

Well said, Ray, which I why I wonder and worry that you subject yourself to Himalayan perils so dangerously often.

All that rarified air! Think of the dangers to your irrigation system, not to mention the external, physical hazards of rotten food, avalanche and landslide; the constant fear of the dreaded Yeti poop-dust in the atmosphere entering your lungs. You owe yourself better.

Far safer in the city, where all you risk is being squashed by a truck, getting held up and robbed, and that without even the basics of a sound, fundamentalist agenda to lend the happening legitimacy.

Rob C

[Petrus]

There are plenty of ailments which are not dependent of lifestyle, like Parkinson's disease or osteoarthritis, the later of which I have at relatively early age. Lifestyle: I hiked for almost 2 months in the Himalaya 3 years before the first replacement, and the Inca Trail 1.5 years before the operation, which was slightly painful I admit. Kilimanjaro I climbed just 2 weeks after the diagnosis in 2008.

People pay taxes for many things also in the USA without much say about the use of money. They pay for basic services like roads, security (police & military) etc. In Scandinavia and some other places also medical care and education are included in the basic services which are equally available to all, just like roads are, without first asking how much one has contributed to their construction. Makes life much easier and less stressful, and free higher education gets at the end paid by those who have taken advantage of it by paying higher taxes from their higher income after graduation.

[Ray]

Well said, Ray, which I why I wonder and worry that you subject yourself to Himalayan perils so dangerously often.

All that rarified air! Think of the dangers to your irrigation system, not to mention the external, physical hazards of rotten food, avalanche and landslide; the constant fear of the dreaded Yeti poop-dust in the atmosphere entering your lungs. You owe yourself better.

Far safer in the city, where all you risk is being squashed by a truck, getting held up and robbed, and that without even the basics of a sound, fundamentalist agenda to lend the happening legitimacy.

Rob C

Rob,
Earthquakes excepted, the dangers of taking exercise in Nepal, trekking in a wondrous environment, are largely in the imagination.

My first great photographic adventure, with my new Pentax Spotmatic, was an amazing trek in Nepal in 1964, in areas where there were no hotels or guest houses. I slept in the houses of farmers in the villages and ate the same food that they ate. I experienced no problems; felt completely safe and don't recall having any stomach upsets or diarrhoea. Maybe I just happen to have very friendly gut bacteria. 

[Ray]

There are plenty of ailments which are not dependent of lifestyle, like Parkinson's disease or osteoarthritis, the later of which I have at relatively early age. Lifestyle: I hiked for almost 2 months in the Himalaya 3 years before the first replacement, and the Inca Trail 1.5 years before the operation, which was slightly painful I admit. Kilimanjaro I climbed just 2 weeks after the diagnosis in 2008.

I would phrase that differently. There are plenty of diseases resulting from particular genetic weaknesses which might not be preventable by a good diet and regular exercise; but such conditions can often be mitigated, or the onset delayed, by a healthy diet and serious, regular exercise, rather than the odd, occasional exercise in the Himalayas or South America.

There are no guarantees in life. Everything is a matter of probability, calculated using as many examples as possible. The more examples examined, the more accurate the probability.

If one is a smoker, and wants to justify continuation of the habit, one can always find examples of people who smoked for most of their life, up until the age of 90 or more, and eventually died of something other than lung cancer. One can also find examples of people who never smoked at all, yet died of, or contracted lung cancer at an early age. These are exceptions.

Denial based upon the observation of rare exceptions can be a huge problem.

[Alan Klein]

That's not a secret. It's common knowledge. Just a matter of the historical record, though, obamacare was lifted pretty much verbatim from an idea the Republicans had floated a short time before.

So, one might wish to take a little care with casting aspersions.

As a consumer of obamacare, I can say that I wish it was a better system.

Sorry.  You get a "F" in History.  You're re-writing it.  The Democrats are totally responsible for Obamacare.  Just because many different kinds of plans were mentioned by many different people in the past means nothing.  The Democrats wrote it (all 1000+ pages of it) without any input from the Republicans.  The Republicans were locked out of all conferences by the Democrats who controlled both the House of Representatives and the Senate at that time.    Not one Republican voted for it.  Every Republican was opposed to the law before it was passed.  And mainly because of Obamacare, both the House and the Senate switched to Republican control in the last election because a majority of the American people didn't like Obamacare.  You are probably the only person in America who thinks the Republicans had any part in foisting Obamacare on America.  

[RSL]

People pay taxes for many things also in the USA without much say about the use of money. They pay for basic services like roads, security (police & military) etc. In Scandinavia and some other places also medical care and education are included in the basic services which are equally available to all, just like roads are, without first asking how much one has contributed to their construction. Makes life much easier and less stressful, and free higher education gets at the end paid by those who have taken advantage of it by paying higher taxes from their higher income after graduation.

Ah, but in the U.S. if you're driving an 18 wheeler on our roads you're paying a hell of a lot more for maintenance of the roads than if you're driving a Chevy Cruze. The other fact is that turnpikes like the Florida Turnpike, which prices your travel essentially by the weight of your vehicle and the distance you travel are much better maintained than are the freeways which are under federal control where road taxes are peed away on things like high speed trains. In the end free enterprise always leaves government control in the dust. That's not a theory. It's a fact borne out by history after history.

[amolitor]

So you didn't look it up. OK, then.

Why you think the voting patterns are relevant is beyond me. They're no more relevant in the contemporary US Congress than they are in Canada or the UK.

[amolitor]

I dunno, Russ. Has free enterprise done much in, say, law enforcement? I honestly can't think of an example, but it's the kind of thing that goes very poorly in the hands of free enterprise.

[DeanChriss]

I'm late to the conversation but here's my 2 cents. I live in the USA, my employer is me and has been for over 30 years, so I've always paid 100% of the insurance/healthcare bill. I get group insurance through a small business organization because exhaustive research showed them to have by far the lowest rates for the best coverage. My wife and I have never had any sort of serious health problem. I've never even been hospitalized, yet our insurance payments would easily buy a new car every year.

Years before healthcare reform I had several insurance rate increases of that were each between 30% and 50%. After healthcare reform there have been other insurance rate increases, but they have been much smaller and more of the preventative measures are covered 100%, which actually saves a little money and helps to prevent bigger bills later on. Still, insurance and healthcare is  certainly the largest expense we have.

I think our healthcare system is incredibly flawed, but a little less so now. We have quite a few very close relatives in Australia and I'm very familiar with their healthcare system. I think it is far better than ours ever was. Having for profit companies in charge of paying out benefits is by definition a conflict of interest. I'd much prefer a system like Medicare for everyone, which was proposed at one point.

[RSL]

I dunno, Russ. Has free enterprise done much in, say, law enforcement? I honestly can't think of an example, but it's the kind of thing that goes very poorly in the hands of free enterprise.

Used to work great when Wyatt was keeping the peace in Dodge, Andrew. But then the government took over.

The problem with law enforcement isn't the cops. It's the politicians running the police departments. That's anything but free enterprise.