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Author Topic: The Tyranny of Medical Bills in America  (Read 102868 times)

Isaac

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Re: The Tyranny of Medical Bills in America
« Reply #180 on: September 15, 2015, 01:30:10 pm »

Can't really see what the big argument is about … US citizens would rather arrange their own healthcare arrangements & expect to pay extra insurance to cover this.

Some US citizens would rather not. Some US citizens would rather have any arrangement more effective and less costly than the current one. That's what the big argument is about.
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Isaac

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Re: The Tyranny of Medical Bills in America
« Reply #181 on: September 15, 2015, 01:39:21 pm »

Competition lowers cost. It also drives up quality and innovation.

For sake of argument, let's accept those claims at face value.

Please show that, in the decade before Obamacare, healthcare insurance premiums became lower and medical bills became lower and healthcare outcomes improved.

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.

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SZRitter

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Re: The Tyranny of Medical Bills in America
« Reply #182 on: September 15, 2015, 01:58:29 pm »

healthcare provision is effectively a monopoly.

Even more so for those of us who don't have multiple hospitals within a small radius. There are a lot of places in the USA that only have one option of where to go. Just like we only have one cable provider, electric company, water company and other services.
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amolitor

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Re: The Tyranny of Medical Bills in America
« Reply #183 on: September 15, 2015, 06:45:42 pm »

I had though you'd been more recent with-spouse, as it were, Rob.

But regardless, it's a beautiful story. In a way they all are, but that detracts from their beauty not in the slightest. Thanks for sharing.
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Alan Klein

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Re: The Tyranny of Medical Bills in America
« Reply #184 on: September 15, 2015, 10:23:51 pm »

Quote
For sake of argument, let's accept those claims at face value. (Alan quote: Competition lowers cost. It also drives up quality and innovation.)

Please show that, in the decade before Obamacare, healthcare insurance premiums became lower and medical bills became lower and healthcare outcomes improved.

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.

=================================================

1. You shop for insurance before you get sick.  In the past, many states did not allow carriers from out of state to sell in their state lowering competition.  Open up competition.  Also, allow insurance companies to tailor their insurance to customer needs and what they want to pay for.

2. Tort reform.  Change the limit on how much you can sue for.  Beside the high cost of medical insurance that adds to doctor charges, doctors often prescribe tests that are not needed because they can argue in court that they did everything possible for the patient.

3. Medicare and Medicaid have been part of the economy for decades.  When the government pays for anything, it raises costs.  Obamacare is accelerating the costs even faster.   Look what has happened to tuition.  Because of government student loans, tuition has gone up four times the CPI inflation rate, all because of too much money chasing too little goods.  Same thing has been happening with medicine and will get worse. 

4. Despite everything, people have been living longer.  Technology has made a very large impact on longevity.    It remains to be seen however that Obamacare will increase longevity.  Costs may hit a point where certain medical procedures may longer be provided for certain diseases for example based on age.  Canada doesn't provide as many MRI's as America because of cost.  That will happen in America effecting medical care. 

Rob C

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Re: The Tyranny of Medical Bills in America
« Reply #185 on: September 16, 2015, 03:53:27 am »

I had though you'd been more recent with-spouse, as it were, Rob.

But regardless, it's a beautiful story. In a way they all are, but that detracts from their beauty not in the slightest. Thanks for sharing.


Thanks - it truly was.

Not to get too introverted for too long, here's a snap that I shot on 135 Kodachrome during our honeymoon. It's a very tight crop from a much larger image, and at the time I had imagined that the best way to save trannies was between glass. Umm no. Let 'em breathe is better, it seems.

It's the only time she wore short hair; when we first met she had Veronica Lake hair, and once it grew back she never cut it short again. Which was cool: she cut mine and I repaid the compliment. It was easy to do: straight hair in a straght line a few inches below the shoulders! Must have saved a fortune on barbers and hairdressers.

Rob C

tom b

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Re: The Tyranny of Medical Bills in America
« Reply #186 on: September 16, 2015, 05:05:39 am »

Bankruptcies resulting from unpaid medical bills will affect nearly 2 million people this year—making health care the No. 1 cause of such filings, and outpacing bankruptcies due to credit-card bills or unpaid mortgages, according to new data. And even having health insurance doesn't buffer consumers against financial hardship.

Article here http://www.cnbc.com/id/100840148.

Cheers,
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Tom Brown

graeme

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Re: The Tyranny of Medical Bills in America
« Reply #187 on: September 16, 2015, 05:18:41 am »

Some US citizens would rather not. Some US citizens would rather have any arrangement more effective and less costly than the current one. That's what the big argument is about.

Yes. But they've been outvoted ( lost the argument ).
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Diego Pigozzo

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Re: The Tyranny of Medical Bills in America
« Reply #188 on: September 16, 2015, 06:02:56 am »

Bankruptcies resulting from unpaid medical bills will affect nearly 2 million people this year...

The main problem with the U.S. is the myth of american exceptionalism, which for many implies that implementing any policy already in place in other countries equates to become "an ordinary nation".
Other nations have universal healthcare, U.S. don't: because of american exceptionalism, U.S. is right and the other nations are wrong.
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jjj

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Re: The Tyranny of Medical Bills in America
« Reply #189 on: September 16, 2015, 07:13:58 am »


The reason is because of the high import duties, excise taxes,  VAT and other taxes added on to pay for 'free" medical care "paid" for by the government. That's the main point frequently missed by those who support government paying for everything.  There is no such thing as a free lunch.  The people pay for everything one way or the other. 

Currently medical care runs 17% of GDP in America going up to 25%.  That's huge mainly caused by Medicare, Obamacare, insurance, and lack of enough competition and going up because competition will decrease faster as these government plans are instituted.   Of course, doctors are figuring ways around the rules.  My friend went to an eye doctor for an annual checkup.  The doctor tested him with a half dozen different devices and tests and charged Medicare for each one of them.  Although the rate for each was low, the quantity made up for it.  Of course my friend didn't care because he wasn't paying for any of it.  But the taxpayers are raising the overall cost of medical care and adding to wasteful procedures.  If my friend had to pay himself, he would have not allowed all those tests.  They were all BS.  This is what happens when the user is not directly paying for things.  The price goes up and the quality goes down. 

No that's what happens when you have a corrupt system.
British healthcare is free and it costs our government less half what the American system does and that was before the Affordable Care Act/Obamacare was introduced in case you try and cite that as the reason.
The reason the American system is so absurdly expensive and inefficient is that there are a stack of parasitic businesses making huge profits off of sick and dying people.
It would be far cheaper for everyone involved i.e. the government and the American people it it was free and paid for directly by the government. Without countless businesses getting in the way and trying to profit off the sick.
What I find most strange about the US and healthcare, is that some people find the thought of helping people ailing people 'un-American' or something. The frothing at the mouth protests by people objecting to Obamacare, simply made the US look like a country full of crazy people. Some of the behaviour by these demented and ill informed people towards sick people was absolutely shameful.

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jjj

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Re: The Tyranny of Medical Bills in America
« Reply #190 on: September 16, 2015, 07:27:43 am »

No, Michael, total cost wasn't $0. What you mean is you didn't have to pay on the spot out of pocket. But you and your neighbors paid through your taxes. I'm not knocking it. I'm just pointing out that costs don't just disappear.
Which stills works out to be vastly cheaper.
Two reasons.
1. No-one is making a profit.
2. Everyone contributing a small amount [that they can afford] they can afford via taxes is actually huge amount of money that can pay for a free at source service.

I can't begin to imagine the costs of my sister's healthcare would have been in the US. Renal failure, dialysis for many years and eventually a transplant.
I have a friend in Seattle who works as a nurse in emergency care. She's had breast cancer, mastectomies and various subsequent complications. She has struggled to afford to pay for this and friends have had to help her out. America should be embarassed buy the fact that someone who may help save your life, can't even afford the healthcare system she is employed by.
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jjj

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Re: The Tyranny of Medical Bills in America
« Reply #191 on: September 16, 2015, 07:33:08 am »

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.
Actually that is exactly what should be done.
Take what is proven to work from wherever and use that. Just don't do a bodged and compromised version.
« Last Edit: September 16, 2015, 07:39:00 am by jjj »
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Diego Pigozzo

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Re: The Tyranny of Medical Bills in America
« Reply #192 on: September 16, 2015, 07:50:18 am »

America should be embarassed buy the fact that someone who may help save your life, can't even afford the healthcare system she is employed by.

I think it's an american people's choice to have such a system.
Whether it's an informed or misguided choice, that's another matter.
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jjj

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Re: The Tyranny of Medical Bills in America
« Reply #193 on: September 16, 2015, 07:54:30 am »


Very true! And it gets worse, there are also other differences between the hospitals. Half the hospitals in Greater Toronto fare worse than the national average when it comes to keeping patients alive following major surgery.

Although the Southlake (Newmarket) hospital is not exactly rural (large modern teaching hospital with 3,000 employees, and over 500 doctors), even more worrisome is the finding by Canadian Institute for Health Information that patients admitted to this facility for stroke are more than twice as likely to die within 30 days as patients admitted for the same condition at The Scarborough Hospital. No information was given about the absolute number of such admissions and the outcome after 30 days, but in this situation doubling of any number is a real concern.

You should be careful to read too much into such bald and often meaningless stats.
The best hospitals and the best doctors may well have the highest number of fatalities.
Why? Because that's where the the patients where the most difficult problems and are most likely to die get sent.

Statistics such as the school league tables we have in the UK are equally pointless and meaningless rubbish.
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Robert Roaldi

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Re: The Tyranny of Medical Bills in America
« Reply #194 on: September 16, 2015, 07:55:36 am »

What I find most strange about the US and healthcare, is that some people find the thought of helping people ailing people 'un-American' or something. The frothing at the mouth protests by people objecting to Obamacare, simply made the US look like a country full of crazy people. Some of the behaviour by these demented and ill informed people towards sick people was absolutely shameful.

The discussion is too often framed in the context of freedom of choice (which pushes a lot of buttons among those who have been primed to react) or as "government-run" healthcare, implying that some civil servant is sitting there in the doctor's office with you deciding what pills to take, or when to let you die. That's not what a single-payer system is, of course, but we're dealing with faith-based beliefs, imo, so facts don't matter. This may be partly the result of clever marketing by the private insurance industry, who have managed to convince people it is a freedom of choice issue. Of course they would, wouldn't they? Interesting that the insurance industry should, in this context, be the "good' guy, when it is almost always universally vilified otherwise.

The fact that large numbers of people can go bankrupt despite having insurance coverage should act as a wake-up but that doesn't seem to the case. I guess the retort is that they should have bought a better insurance policy, so it is really the sick person's fault. The people who buy the wrong policy stay sick and die early, or at least suffer a lot more; must be that creative destruction I keep hearing about.

But there may be a more fundamental thing going on. Some people believe that the reason humans form into groups and eventually societies is for the general benefit of all. Not everyone necessarily believes that. Some people believe that society exists as a support system for the successful. The notion that private enterprise is just one method we've invented to deliver some goods and services and that we should not expect it to always work in all sectors is not an acceptable point of view among some people. Government is always bad, it seems, except magically when it comes to security or intelligence or the military, then the government becomes a sainted presence to be revered and it is treason not to think so. As if things are that black and white.

There is also a knee-jerk belief that government-run enterprises always work out badly and cost too much. It's easy to come to that belief, those stories will always get media attention. I've worked mostly in the private sector and a little in the public sector, and the idea that private industry is efficient and government is not just makes me laugh out loud. I can certainly find examples of government inefficiency but so what. The fact that we don't hear about boondoggles in the private sector is only because no one can investigate and report on them as easily as you can in the public sector. Freedom of information doesn't apply to private companies. And anyway, no one regards those private boondoggles as things that affect them. Except for maybe those pesky financial meltdowns, but people find a way to blame that on government too.

It's a bit of "Four legs good, two legs better", isn't it?

What constantly fascinates me is how many people are more concerned with ideology than by trying to figure out what works best.
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Diego Pigozzo

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Re: The Tyranny of Medical Bills in America
« Reply #195 on: September 16, 2015, 08:04:59 am »

What constantly fascinates me is how many people are more concerned with ideology than by trying to figure out what works best.

It's nothing strage, in fact: our brain evolved to save our ass, not to earn the nobel price, which means that it is hardwired to use the simplest convincing theory, not the more proper one.
Thinking is hard (literally), so yes: "Four legs good, two legs better" because so many say it.
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tom b

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Re: The Tyranny of Medical Bills in America
« Reply #196 on: September 16, 2015, 08:52:13 am »

"I think the issue with most Americans is not what's necessarily best for them.  It's much about not having the government telling us what to do and how to live."

The essential difference between America and Australia. Most immigrants come to Australia for a better life.

Cheers,
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Tom Brown

RSL

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Re: The Tyranny of Medical Bills in America
« Reply #197 on: September 16, 2015, 10:22:10 am »

Which stills works out to be vastly cheaper.
Two reasons.
1. No-one is making a profit.

Tell me what you think "profit" is, Jeremy.
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RSL

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Re: The Tyranny of Medical Bills in America
« Reply #198 on: September 16, 2015, 11:46:35 am »

British healthcare is free. . .

HA HA HA HA HA HA, OUCH, HA HA HA HA. ROTFL!
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LesPalenik

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Re: The Tyranny of Medical Bills in America
« Reply #199 on: September 16, 2015, 12:25:32 pm »

You should be careful to read too much into such bald and often meaningless stats.
The best hospitals and the best doctors may well have the highest number of fatalities.
Why? Because that's where the the patients where the most difficult problems and are most likely to die get sent.

Statistics such as the school league tables we have in the UK are equally pointless and meaningless rubbish.

Good point! Conversely, some smaller hospitals that don't handle the more critical cases, may fare better in the statistics.
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