Healthcare costs -- the Brill article

[Meathead]

i wasnt going to spell this out bc it should be so self evident anyway but the public option would also solve many problems listed in that article by being the lowest default option. coverage wouldnt be as good as insurance industry plans but virtually everyone would be covered and plan administration would define price points, completely eliminating things like the chargemaster fiasco

 

now go get your blanket and after your nap we will have milk and cookies when we restart debate club

[Magox]

i wasnt going to spell this out bc it should be so self evident anyway but the public option would also solve many problems listed in that article by being the lowest default option. coverage wouldnt be as good as insurance industry plans but virtually everyone would be covered and plan administration would define price points, completely eliminating things like the chargemaster fiasco

 

now go get your blanket and after your nap we will have milk and cookies when we restart debate club

No it wouldn't, again you are talking out of your ass. The public option was simply a government run health insurance agency meant to compete with private health insurers with the hope of being able to create greater leverage in negotiating with hospitals and doctors. just quit talking about this subject, you clearly showed not just in your previous two posts but in the prior discussion that this is one subject that you are clueless on.

 

So there is an 11 page article that is primarily about the way hospitals over charge and what you got out of it was, we need the public option.

 

Idiot

[birdog1960]

Did you even read the article? If you did, then what you just proved to anyone who actually read and understood it is that you are a complete blithering idiot. The article had virtually nothing to do with excessive profits from the private health insurers but much more so with the inefficient delivery system of medicine here in the U.S.

 

The reason why the public option was ever brought up was so it would provide more "competition" amongst the insurers, because there was a false predominant belief from many that rising health insurance premiums were being driven by greed from the health insurance industry, which of course is false. If you had read the article and took it for what it was worth, you would see that premiums are being driven by..... Drum roll please.......... Health care costs, What the author proposes are ways to limit overcharging from the providers not the insurers,

 

 

Your post helped confirm what I pretty much thought, which is that you're an idiot

no, if you read the article and especially if you listened to brill on pbs , you'd understand that he thinks that the healthcare industry has been at full employment and is making record profits in a recession because very often demand is not discretionary and there's little competition for price. prices are not disclosed to direct individual payers til after the fact. small providers are getting squeezed out by massive "nonprofits" that often are the largest and best paying employers in an area, often with huge top executive salaries. they lobby the govt at levels that dwarf even the military contractors. while private insurers take a cut of healthcare spending amounting to billions, they are losing ground in the power battle with the large systems. the only players having any success at modulating costs recently have been the gov't programs: medicare and medicaid. and this entire ridiculous scenario is uniquely american. because we are the only country that prioritizes profits, at nearly every level of care provision, over actually providing care. yes, that includes malpractice lawyers but also layers and layers of managers and businessmen whose primary purpose it is to maximize profit at every enterprise including insurance. profit taking costs the payers, whether individuals, insurance companies or the government. no matter your opinion on the solution, it's very clear that this system is failing and is unsustainable. with health costs comprising nearly double that of most other developed countries as a proportion of gdp, we cannot compete effectively for costs of products produced with these costs factored in. Edited March 3, 2013 by birdog1960

[birdog1960]

No it wouldn't, again you are talking out of your ass. The public option was simply a government run health insurance agency meant to compete with private health insurers with the hope of being able to create greater leverage in negotiating with hospitals and doctors. just quit talking about this subject, you clearly showed not just in your previous two posts but in the prior discussion that this is one subject that you are clueless on.

 

So there is an 11 page article that is primarily about the way hospitals over charge and what you got out of it was, we need the public option.

 

Idiot

well if you want to point to someone who misinterpreted the article, how bout meazza? he thinks it's about rich and poor getting different levels of care. i guess that's because the patient that went to texas for cancer care chose a "cadillac" option for care. first of all, that wasn't brill's point. secondly, the cost wouldn't likely have been much lower at podunk community hospital. THAT was the point i believe brill was making.. and the idea that everyone gets equal care regardless of ability to pay is a strawman. i didn't read brill nor have i read any mainstream proponents of universal coverage demanding it. most want chevy levels of care for everyone. if you want more bells and whistles and can afford it, that's fine. to me those are the profit sources that are most appropriate for exploitation if we continue to insist on a for profit system.

[dayman]

Only one insurer pays anywhere close to cost

[birdog1960]

Only one insurer pays anywhere close to cost

huh? then why the operating margins brill cites for the big systems? that's not all coming from private payers.

[B-Large]

 

 

Would you still be such a one trick pony if you didn't have a personal reason for wanting government backed insurance? What if the government provided health insurance for all people with existing conditions at let's say a premium of 20% over average health insurance costs? Would you then forego your constant advocation for everything Obamacare?

 

 

 

So "funding" is now the equivalent of handing out a bunch of post dated checks on an account with no money in it?

 

I would have been fine with that scenario from the start, in fact, I thought John McCains platform for Heathcare in 2008 was better with high risk pools, HSA's and regulatory and legal reform.... Republicans had many chances to address the Healthcare issue, they didn't, we got what we got..

 

I am not a cheerleader for the Affordable Care Act, as much as you want to believe so, at this point just glad for 2014 and the ability to buy insurance without having to work at a job with group insurance.. Being a prisoner to some job just to have Heath benefits isn't freedom, it's pathetic...

 

to me that article just confirms what ive said all along, that it was a huge mistake to remove the public option from health care reform. the one and only reason i would ever want the dems to regain total control would be to get that part back into the system

 

Public option only if it has he ability to negotiate with providers directly, drug companies directly, rehab/ durable medical goods directly, etc..... No more of this "drug companies exempt from negotiation" crap....

 

Only one insurer pays anywhere close to cost

 

Medicare pays so low because the private insurers make up the difference, on top of private insurers 20 percent cut for overhead and administrative burden.... For a country that prides itself on how innovative and forward thinking we are, we sure fail in Healthcare finance...

[birdog1960]

did anybody notice the bit about employment opportunities and potential earnings for salesmen for items like mri machines for companies like seimens? these facts are emblematic of the problem to me. americans are effectively led to believe that more is always better even if there isn't evidence to support that contention. if they don';t get more they feel they are being cheated. this is certainly the case for many radiologic studies.. these are profit centers for health systems and they seem happy to do as many studies as they can. doctors often do them out of fear of malpractice cases. in both cases, the root cause is the desire to make money off of the system. and plenty of people are making plenty of money that is not going towards providing effective care. this is where a board of true experts defining national evidence based standards of care would help immensely. unfortunately, the seed has been planted in the minds of the american public that the purpose of such a board would be to limit effective care when it could truly be to provide it more effectively. this, of course, is directly confronting the goals of many in the game: increased profits.

Edited March 3, 2013 by birdog1960

[Alaska Darin]

unfortunately, the seed has been planted in the minds of the american public that the purpose of such a board would be to limit effective care when it could truly be to provide it more effectively. this, of course, is directly confronting the goals of many in the game: increased profits.

In the short term, that may actually work. In the long term, lobbyists and politicians will turn it into another boondoggle that will cost the taxpayers billions upon billions and ensure the game is controlled by someone who doesn't have the patient's best interest in mind. JUST LIKE EVERYTHING ELSE.

 

I know that's a tough thing for you liberals to face but big government/central control has never made anything more affordable for the average person. It's always the opposite. ALWAYS.

[birdog1960]

In the short term, that may actually work. In the long term, lobbyists and politicians will turn it into another boondoggle that will cost the taxpayers billions upon billions and ensure the game is controlled by someone who doesn't have the patient's best interest in mind. JUST LIKE EVERYTHING ELSE.

 

I know that's a tough thing for you liberals to face but big government/central control has never made anything more affordable for the average person. It's always the opposite. ALWAYS.

other governments are getting it more correct compared to our private/public system in terms of results versus costs. (i'll grant that many, if not all, have their problems but not as serious as ours in regards to costs) are you arguing that american gov't is uniquely destined for failure in this regard.

[Magox]

no, if you read the article and especially if you listened to brill on pbs , you'd understand that he thinks that the healthcare industry has been at full employment and is making record profits in a recession because very often demand is not discretionary and there's little competition for price. prices are not disclosed to direct individual payers til after the fact. small providers are getting squeezed out by massive "nonprofits" that often are the largest and best paying employers in an area, often with huge top executive salaries. they lobby the govt at levels that dwarf even the military contractors. while private insurers take a cut of healthcare spending amounting to billions, they are losing ground in the power battle with the large systems. the only players having any success at modulating costs recently have been the gov't programs: medicare and medicaid. and this entire ridiculous scenario is uniquely american. because we are the only country that prioritizes profits, at nearly every level of care provision, over actually providing care. yes, that includes malpractice lawyers but also layers and layers of managers and businessmen whose primary purpose it is to maximize profit at every enterprise including insurance. profit taking costs the payers, whether individuals, insurance companies or the government. no matter your opinion on the solution, it's very clear that this system is failing and is unsustainable. with health costs comprising nearly double that of most other developed countries as a proportion of gdp, we cannot compete effectively for costs of products produced with these costs factored in.

Thats not what the article said or implied. There was very little that had to do with the inefficiencies of the health insurers. The article was about the delivery system of medicine and how it is charged to the public. The only straw man here is your perception of the private health insurers.

 

Maybe brill advocated what you said in an interview, but that is not what he was talking about in the article.

 

did anybody notice the bit about employment opportunities and potential earnings for salesmen for items like mri machines for companies like seimens? these facts are emblematic of the problem to me. americans are effectively led to believe that more is always better even if there isn't evidence to support that contention. if they don';t get more they feel they are being cheated. this is certainly the case for many radiologic studies.. these are profit centers for health systems and they seem happy to do as many studies as they can. doctors often do them out of fear of malpractice cases. in both cases, the root cause is the desire to make money off of the system. and plenty of people are making plenty of money that is not going towards providing effective care. this is where a board of true experts defining national evidence based standards of care would help immensely. unfortunately, the seed has been planted in the minds of the american public that the purpose of such a board would be to limit effective care when it could truly be to provide it more effectively. this, of course, is directly confronting the goals of many in the game: increased profits.

 

Again, this point has nothing to do with the public option

 

well if you want to point to someone who misinterpreted the article, how bout meazza? he thinks it's about rich and poor getting different levels of care. i guess that's because the patient that went to texas for cancer care chose a "cadillac" option for care. first of all, that wasn't brill's point. secondly, the cost wouldn't likely have been much lower at podunk community hospital. THAT was the point i believe brill was making.. and the idea that everyone gets equal care regardless of ability to pay is a strawman. i didn't read brill nor have i read any mainstream proponents of universal coverage demanding it. most want chevy levels of care for everyone. if you want more bells and whistles and can afford it, that's fine. to me those are the profit sources that are most appropriate for exploitation if we continue to insist on a for profit system.

Even if you we're to accept your argument that a lot of the problems is based on profit, (which is tremendously short-sighted), but lets say we did accept that, everything brill was talking about was again, the delivery of medicine, not the insurers. So the biggest straw,an f them all regarding this subject is believing that if we reform the insurers that it would help solve the problem of rising costs.

[birdog1960]

Thats not what the article said or implied. There was very little that had to do with the inefficiencies of the health insurers. The article was about the delivery system of medicine and how it is charged to the public. The only straw man here is your perception of the private health insurers.

 

Maybe brill advocated what you said in an interview, but that is not what he was talking about in the article.

 

 

 

Again, this point has nothing to do with the public option

 

 

what do you think he meant by this statement:"the result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high tech implants to CT scans..." i think i know what he's getting at and agree completely.

[Magox]

Also, the "health care industry" is not primarily the health insurance industry. It encompasses a whole swath of sectors, all related health care. Again, nothing that the public option would effect in a meaningful way. Did you read his summary conclusion? No where does he mention reforming the health insurers. His solutions were solely reforming how the provides of healthcare should charge.

 

what do you think he meant by this statement:"the result is a uniquely American gold rush for those who provide everything from wonder drugs to canes to high tech implants to CT scans..." i think i know what he's getting at and agree completely.

It's simple, he believes that profits are a factor when it comes to medical price inflation. And I agree with that. But again, that has nothing to do with the insurers.

[birdog1960]

Thats not what the article said or implied. There was very little that had to do with the inefficiencies of the health insurers. The article was about the delivery system of medicine and how it is charged to the public. The only straw man here is your perception of the private health insurers.

 

 

 

 

Even if you we're to accept your argument that a lot of the problems is based on profit, (which is tremendously short-sighted), but lets say we did accept that, everything brill was talking about was again, the delivery of medicine, not the insurers. So the biggest straw,an f them all regarding this subject is believing that if we reform the insurers that it would help solve the problem of rising costs.

agreed. he didn't place much blame on private insurers and made the point that they are becoming less important. i agree with this also although i don't think they are part of the solution. . he also didn't greatly champion single payer as the solution. i do . his main point, as i interpreted it, was the perverse incentives that exist in the American heath industry and their negative effects to both patients and our economy.

 

can we agree that the article was an indictment of the current system?

Edited March 3, 2013 by birdog1960

[Magox]

Those examples he cited there are the drug and medical device makers. He also believes that hospitals and their administrators and their methods of charging patients are large factors. Yet again, that has nothing to do with the entities that end up paying for these inflated charges.

[Alaska Darin]

other governments are getting it more correct compared to our private/public system in terms of results versus costs. (i'll grant that many, if not all, have their problems but not as serious as ours in regards to costs) are you arguing that american gov't is uniquely destined for failure in this regard.

I wouldn't say I'm arguing anything. The fact is there's more money in the American political system than the GDP of all but a handful of countries. That generally means more bureaucracy and more corruption.

 

Like I said, I'm sure it would start out on track but it wouldn't take long for it go completely off the rails.

 

This country desperately needs someone to press the reset button. We don't need this much government and the government we should have needs to be accountable. Good luck getting that fixed.

 

No one's arguing that health care in the U.S. isn't desperately !@#$ed up. I've said the same thing on this board numerous times that Brill wrote in his article. ACA didn't address those things or any of the other things that make health care ridiculously expensive. The reason for that has everything to do with politicians (regardless of affiliation) being in the pockets of lobbyists and the apathy/stupidity of the publicly educated populous.

 

You liberals are getting exactly what you deserve.

[Magox]

Did anyone happen to catch what brill said about the ACA?

 

He said what it did help solve is who will pay for it? What it didn't solve was to effectively bring down health care costs.

 

That's pretty much what I've been saying from day one

[birdog1960]

Those examples he cited there are the drug and medical device makers. He also believes that hospitals and their administrators and their methods of charging patients are large factors. Yet again, that has nothing to do with the entities that end up paying for these inflated charges.

and i contend that this is the only way a for profit medical system can evolve. it's the natural outcome for the design (which is really not a product of design but of lack of design). remove or severely limit the incentive (profit) and you remove much of the problem. devise a system that prioritizes providing care over providing profits. the aca isn't a perfect or particularly good solution but is more so than anything i've seen presented by the other side.

[Magox]

and i contend that this is the only way a for profit medical system can evolve. it's the natural outcome for the design (which is really not a product of design but of lack of design). remove or severely limit the incentive (profit) and you remove much of the problem. devise a system that prioritizes providing care over providing profits. the aca isn't a perfect or particularly good solution but is more so than anything i've seen presented by the other side.

We can discuss the merits and pitfalls of the "for profit" health care industry. Without a doubt that the innovations in medical equipment, drugs etc have improved as a result, but I also would agree that it has contributed to medical price inflation. But as you can see from his view, there are many other factors as well and no where were the private insurers listed as one of his problem areas. If anything he sympathized with them and the doctors.

 

But my whole point was to point out the absurdity of meatface's post. Which what he said was what "he got out" of this article was that we need the public option. That's fine if you believe we need one, but don't chime in and say that the article suggested a need of a government run private insurer to compete when the article had everything to do with the delivery and charging methods of the PROVIDERS

[birdog1960]

We can discuss the merits and pitfalls of the "for profit" health care industry. Without a doubt that the innovations in medical equipment, drugs etc have improved as a result, but I also would agree that it has contributed to medical price inflation. But as you can see from his view, there are many other factors as well and no where were the private insurers listed as one of his problem areas. If anything he sympathized with them and the doctors.

 

But my whole point was to point out the absurdity of meatface's post. Which what he said was what "he got out" of this article was that we need the public option. That's fine if you believe we need one, but don't chime in and say that the article suggested a need of a government run private insurer to compete when the article had everything to do with the delivery and charging methods of the PROVIDERS

ok. i agree this article didn't support single payer or the aca as the solution. it wasn't really about solutions. it illuminated the problems, which are many. there is no single solution but for problems so deep i believe fundamental change is required. that's not what many folks are proposing. they believe the market place can solve these issues. i believe the free market in health care is much of the problem. buying and selling care for a heart attack isn't in any way similar to buying a big screen tv or car. and that truth is well illustrated in this piece. Edited March 3, 2013 by birdog1960