birdog1960 Posted January 23, 2014 Posted January 23, 2014 I think its a useful distinction. Single payor to me means 1 insurance provider (generally the government) and private delivery of care services. Whereas in places like U.K. you have government both paying for and delivering health services, which in my mind is more akin to the traditional definition of socialism. actually, even the way tom apparently envisions it and in places like england and canada, it's not truly single payor or socialism. there are still free markets there for health care ouytside the national systems. there are also independent insurance products (ie multiple payors). your definition is closer to what i believe most policy wonks intend when speaking of "single payor". i would however, add to your description: 1 "predominant" insurance provider (generally the govt) to comply with the actuality noted above.
OCinBuffalo Posted January 23, 2014 Posted January 23, 2014 Serious question, based your logic, why would people even accept government work if it doesn't cover their cost? Why not just do all private work where they "charge more" according to you. Because... oh...wait...birdog should know the answer...let's see what he says: it's called concierge medicine and there are a few such clinics. none that i'm aware of in ortho: it's too expensive for all but the less than 1%. they'd need to charge even more than they are to the private insurers (eg $40k for a hip replacement). btw, that cost is not that far out of line with medicare payments when you factor in what hospitals are paid for theier rooms while the patient is there for the procedure and after care.. well, so much for that idea. Birdog is either being clueless on purpose, or he really doesn't understand how his own industry actually works. JuanGuzman: The reason most orthos take both Medicare/Medicaid and private insurance? Because they've got a contract with a hospital where they do their surgery. Most hospitals take Medicare/Medicaid(because they are likely to be forced to at the emergency room anyway), so, part of that contract says the othro will take Medicare/Medicaid as well. That, and many doctors actually, with a straight face, believe they are doing the right thing by taking Medicare/Medicaid. It's like Pro Bono for lawyers. They don't mind doing the extra hip replacement here and there. If they have to do a lot, they have to balance things out, as I've said. Which, is why they don't make that big of a deal out of having to take on Medicare/Medicaid patients. The whole point of all of this remains: Government Health Care "cuts" its "cost" by not paying its bills. Moving to a 100% government system means moving 100% toward decreased quality and efficiency. You cannot take money out of the system abitrarily, by simply refusing to pay the full price for what you are getting no matter the quality, and expect quality to be maintained. Why would anyone deliver a quality service, when they get paid the same for delivering a "budget" service? you're a ball of laughs. did you even glance at the aussie email. i'll bet you sided with the rude mechanical neighbor. didn't you? huh? Of course I noticed the aussie email. That's hilarious. Now, explain to everyone here why you are spreading a lie about "hip replacement".
JuanGuzman Posted January 23, 2014 Posted January 23, 2014 That's hilarious. Now, explain to everyone here why you are spreading a lie about "hip replacement". Instead of getting into argument about how much precedure X cost versus procedure Y. Why don't we post per-capita health spending I think the high cost of health care in the U,S, is one of many reasons people seek health care outside the USA (experimental treatments can be another) Whatever a hip replacement costs, the point is its frieken expensive to get health care in the USA
IDBillzFan Posted January 23, 2014 Posted January 23, 2014 Whatever a hip replacement costs, the point is its frieken expensive to get health care in the USA Tell me about it. Makes you wonder...what kind of a fool would force a massive law on all Americans that makes health care even MORE expensive than it already is?!?!? Thanks, Obama! You da best!
birdog1960 Posted January 23, 2014 Posted January 23, 2014 (edited) Now, explain to everyone here why you are spreading a lie about "hip replacement". it's not a lie. depending on which american hospital it's done at, charges for a total hip can range from 15K to 100K and that's what you'd be billed with no insurance. the numbers you linked (without any legend for the acronyms btw) were for payments to the physicians only. you left off the implant itself which can cost more than 10K alone and all the other costs included in the drg payment (and isn't it nice how in this regard the hospitals and surgeons primary concern is not the pt but their own pockets- ah, the wonders of the free market) http://www.npr.org/b...eon-doesnt-know. the 15-100k figure for for total hip comes from a fairly recent JAMA article that looked at the "transparency" of pricing in hospitals. you can look that one up for yourself. within the same article, 10-25K is the number given for payments from medicare to the hospital for the procedure. at the higher number, one could still live in spain for a year or 2, learn the language and run the bulls with the savings. Edited January 23, 2014 by birdog1960
JuanGuzman Posted January 23, 2014 Posted January 23, 2014 Tell me about it. Makes you wonder...what kind of a fool would force a massive law on all Americans that makes health care even MORE expensive than it already is?!?!? Thanks, Obama! You da best! Affordable Care will do a better job controlling costs then the statusquo. In fact a lot estimates seem to show the health cost curve is bending. Not only will care be more affordable but more people will be insured. Goodbye 50 million uninsured americans, hello health insurance for people working part time, waitresses, barbers, minimum wage workers etc. Obama care ain't perfect but its a step in the right direction for America.
B-Man Posted January 24, 2014 Posted January 24, 2014 HEY, Where are all those uninsured people who were supposed to be signing up for OBAMACARE? “There may be something seriously wrong with our understanding of who the uninsured are, and what they are willing and able to buy in the way of insurance. I don’t know exactly what the fault may be in our understanding. But if the numbers stay this low, I’d say we need to reassess the state of our knowledge about the uninsured — and the vast program we created to cover them.” Maybe the whole thing was a crock — or just an excuse for a government takeover of a huge industry. So the answer to the link in my post #119 (What was the point of Obamacare again ?) in a single word: compulsion. That derisive sneer on the face of Nancy Pelosi as she and the other Democrat perps did their classless said all that needed to be said about the real purpose of Obamacare. And what it said was: because we can. .
IDBillzFan Posted January 24, 2014 Posted January 24, 2014 Affordable Care will do a better job controlling costs then the statusquo. In fact a lot estimates seem to show the health cost curve is bending. Not only will care be more affordable but more people will be insured. Goodbye 50 million uninsured americans, hello health insurance for people working part time, waitresses, barbers, minimum wage workers etc. Obama care ain't perfect but its a step in the right direction for America. Obamacare is the biggest FUBAR'ed mistake this country has made in years and will do NOTHING you think it will because it will implode long before it has any chance of helping those who need it. There is no cost curve bending verified by anyone but the knob-gobblers working for the WH, and if you have been paying any attention to ANY of the reality, you would realize the truer statement is "Goodbye 50 million uninsured Americans, hello 100 Million uninsured Americans, because THAT is what is taking place before your very blindfolded eyes. But hey...status quo...step in the right direction...whatever makes you feel better.
B-Man Posted January 24, 2014 Posted January 24, 2014 THE HILL: Poll: Obama gets low marks on healthcare. TRAIN WRECK UPDATE: MN ObamaCare exchange failing, panel recommends scrapping system. Obama Healthcare Adviser Leaving Due to Health Reasons .
Doc Posted January 24, 2014 Posted January 24, 2014 Obamacare is the biggest FUBAR'ed mistake this country has made in years and will do NOTHING you think it will because it will implode long before it has any chance of helping those who need it. There is no cost curve bending verified by anyone but the knob-gobblers working for the WH, and if you have been paying any attention to ANY of the reality, you would realize the truer statement is "Goodbye 50 14 million truly uninsured Americans (most of who don't want Obamacaid), hello 100 Million uninsured Americans, because THAT is what is taking place before your very blindfolded eyes. But hey...status quo...step in the right direction...whatever makes you feel better. Fixed it for you.
3rdnlng Posted January 24, 2014 Posted January 24, 2014 Affordable Care will do a better job controlling costs then the statusquo. In fact a lot estimates seem to show the health cost curve is bending. Not only will care be more affordable but more people will be insured. Goodbye 50 million uninsured americans, hello health insurance for people working part time, waitresses, barbers, minimum wage workers etc. Obama care ain't perfect but its a step in the right direction for America. Nothing like living back in 2010.
OCinBuffalo Posted January 24, 2014 Posted January 24, 2014 (edited) Instead of getting into argument about how much precedure X cost versus procedure Y. Why don't we post per-capita health spending I think the high cost of health care in the U,S, is one of many reasons people seek health care outside the USA (experimental treatments can be another) Whatever a hip replacement costs, the point is its frieken expensive to get health care in the USA So, after I specifically point out that it doesn't arbitrarily cost $41k for a hip replacement? Now it doesn't matter what it costs? OK, so much for that dopey meme then. Now, to your next point: tell me which country on that list doesn't have socialist health care? (See...this is where they think they are going to win) All of them you say? Ok, and how many of them "manage costs" by simply not paying for things, or paying a pittance for it? Or, denying cancer treatment, or, denying organ transplants...basically the highest ticket items? How many of them have private insurance that runs right along side, paid by employers, because if you don't have it....then you are subjected to rationing? Answer: ALL of them. Is private insurance spending included in your graph, or don't you even know to ask that question? Why do you need private insurance at all...in Japan...if the government insurance is the answer? Hey, I know: let's talk some Japan health care, shall we? Some medical treatments are not covered by National Health Insurance or Employees' Health Insurance. These treatments include some pre-natal care, deliveries and pregnancy terminations, voluntary vaccinations, orthodontics, and health check-up exams.http://www.internati...ce-in-japan.php Think that list is exhuastive? Nope! Now here's a real shocker coming up next. It's not like we see the exact same thing happening everywhere socialized medicine exists: For any particular service, the same fee is paid by all insurers to all providers. As in Canada or Germany, there is no "extra-billing": neither physicians nor hospitals may bill their patients more than the authorized fee; but illegal side-payments are common and condoned. http://www.nyu.edu/p...lessons.html#IV (and here's right around the point where they realize, oh crap, by using this dopey graph, I'm not winning, I'm making his point for him) Um....how does your graph look now? Does it account for the common and condoned side payments? Factor that in did ya? And how about this? Hospitals can bill patients extra only for room and board and a restricted number of specialized services, for example.19 As John Campbell noted at the conference, "cheap stuff is profitable and expensive stuff is unprofitable. A doctor who sees a few extra patients and prescribes drugs for them makes money; coronary bypass surgery at an urban hospital loses money." Yeah....nothing like an objective graph that talks about "spending", but not actually about COST! If you refuse to pay for things, or have a government bureacrat(s) decide that "you've lived long enough, and certainly aren't worth dropping $300k on for a heart transplant"? By defintion, you're going to generate lower "per capita health spending". Yeah: if it's your policy not to spend money on the life-saving stuff = high cost stuff, you will amazingly find yourself: spending less money. Got any more tautological "insight" for us? Or, are you still stuck on the common and condoned illegal side-payments? it's not a lie. depending on which american hospital it's done at, charges for a total hip can range from 15K to 100K and that's what you'd be billed with no insurance. the numbers you linked (without any legend for the acronyms btw) were for payments to the physicians only. you left off the implant itself which can cost more than 10K alone and all the other costs included in the drg payment (and isn't it nice how in this regard the hospitals and surgeons primary concern is not the pt but their own pockets- ah, the wonders of the free market) http://www.npr.org/b...eon-doesnt-know. the 15-100k figure for for total hip comes from a fairly recent JAMA article that looked at the "transparency" of pricing in hospitals. you can look that one up for yourself. within the same article, 10-25K is the number given for payments from medicare to the hospital for the procedure. at the higher number, one could still live in spain for a year or 2, learn the language and run the bulls with the savings. Ah, see? Where was all this nuance in your douchy little $41k hip replacement meme birdog? The point is: all the things we can do with $41k.....but not realize that a US citizen will NEVER EVER go to Spain and get a hip replacement for anything less than $41k, you twit. You did know this stuff, and were just being a giant D-bag before. That's OK, as long as you are willing come clean now. The simple fact is: (and I'm currently proving this every single day recently) ALL patients are different, with different needs and therefore, different costs. One wonders then: why in God's name any supposedly rational doctor is willing to subscribe to a "one-size-fits-all" health care schema..... Affordable Care will do a better job controlling costs then the statusquo. In fact a lot estimates seem to show the health cost curve is bending. Not only will care be more affordable but more people will be insured. Goodbye 50 million uninsured americans, hello health insurance for people working part time, waitresses, barbers, minimum wage workers etc. Obama care ain't perfect but its a step in the right direction for America. You really have no idea what the word cost means, do you? As we've demonstrated above, you think COST = spending. Therefore, you don't have any idea how to reduce cost, or how to even begin building a plan to reduce cost. It's bizarre really, somebody talking about cost as though it's some abstract thing like "anger". You: "Yes, this thing over here will "reduce anger" for no other reason than, I believe it will." Your assumptions here are so backward, as I've stated above, that it's hard to know where to begin fixing you. Edited January 24, 2014 by OCinBuffalo
DC Tom Posted January 24, 2014 Posted January 24, 2014 You really have no idea what the word cost means, do you? As we've demonstrated above, you think COST = spending. Therefore, you don't have any idea how to reduce cost, or how to even begin building a plan to reduce cost. It's bizarre really, somebody talking about cost as though it's some abstract thing like "anger". You: "Yes, this thing over here will "reduce anger" for no other reason than, I believe it will." Your assumptions here are so backward, as I've stated above, that it's hard to know where to begin fixing you. I'm not surprised you wasted your time (you being you). I am surprised that you didn't point out that "costs," or even per-capita spending, between countries isn't necessarily comparable, and certainly not by a simple bar chart.
OCinBuffalo Posted January 24, 2014 Posted January 24, 2014 I'm not surprised you wasted your time (you being you). I am surprised that you didn't point out that "costs," or even per-capita spending, between countries isn't necessarily comparable, and certainly not by a simple bar chart. Yes, yes, whatever. Besides, I said, I don't know where to begin, did I not? What the hell do you want? You want to begin with that? Go ahead! I'd rather stick to the same old thing we see with government-anything: sooner or later it's always about pay-offs. Some questions? Why does anyone ever need to do side payments with these "low per capita spending" systems? What could the possible motivation be? Why would one doctor get paid off more than another one? Why would another doctor not get any payoff? Do I detect a market at work?
birdog1960 Posted January 24, 2014 Posted January 24, 2014 (edited) So, after I specifically point out that it doesn't arbitrarily cost $41k for a hip replacement? Now it doesn't matter what it costs? OK, so much for that dopey meme then. Now, to your next point: tell me which country on that list doesn't have socialist health care? (See...this is where they think they are going to win) All of them you say? Ok, and how many of them "manage costs" by simply not paying for things, or paying a pittance for it? Or, denying cancer treatment, or, denying organ transplants...basically the highest ticket items? How many of them have private insurance that runs right along side, paid by employers, because if you don't have it....then you are subjected to rationing? Answer: ALL of them. Is private insurance spending included in your graph, or don't you even know to ask that question? Why do you need private insurance at all...in Japan...if the government insurance is the answer? Hey, I know: let's talk some Japan health care, shall we? Think that list is exhuastive? Nope! Now here's a real shocker coming up next. It's not like we see the exact same thing happening everywhere socialized medicine exists: (and here's right around the point where they realize, oh crap, by using this dopey graph, I'm not winning, I'm making his point for him) Um....how does your graph look now? Does it account for the common and condoned side payments? Factor that in did ya? And how about this? Yeah....nothing like an objective graph that talks about "spending", but not actually about COST! If you refuse to pay for things, or have a government bureacrat(s) decide that "you've lived long enough, and certainly aren't worth dropping $300k on for a heart transplant"? By defintion, you're going to generate lower "per capita health spending". Yeah: if it's your policy not to spend money on the life-saving stuff = high cost stuff, you will amazingly find yourself: spending less money. Ah, see? Where was all this nuance in your douchy little $41k hip replacement meme birdog? The point is: all the things we can do with $41k.....but not realize that a US citizen will NEVER EVER go to Spain and get a hip replacement for anything less than $41k, you twit. You did know this stuff, and were just being a giant D-bag before. That's OK, as long as you are willing come clean now. The simple fact is: (and I'm currently proving this every single day recently) ALL patients are different, with different needs and therefore, different costs. One wonders then: why in God's name any supposedly rational doctor is willing to subscribe to a "one-size-fits-all" health care schema..... do you never tire of the black/white dualist thought? i sure do. a system that calculates values for procedures in terms such as cost per years of life and then has the national discussion on whether that cost is appropriate is a far cry from what you describe. who are the people proposing a "just say no" approach to allocation of health dollars? names please.. on the other hand i feel confident that we can put you down in the column that if you've paid into medicare fully, you should be able to "recoup" unlimited multiples of your premium payments for any procedure at any cost. even the most ardent repugnant con pols know that course is unsustainable even for a few short years but are rarely willing to admit it. returning to the hip replacement (cuz you all just can't seem to grasp any part of the point - perhaps being just a tad less pedantic and literal would help), 750,000 americans per year isn't "never ever" (if you're stuck on spain, please refer to the above suggestions). take a look at this site http://www.allmedica...ip-replacement/ and then tell me that most of these people are looking at experimental treatments. hell, i personally know more than few folks that have done this, had good outcomes and saved enough cash to go on a couple nice real vacations later. Edited January 24, 2014 by birdog1960
Nanker Posted January 24, 2014 Posted January 24, 2014 Mitt Romney drove his horse on the roof of his car clear across country.
3rdnlng Posted January 24, 2014 Posted January 24, 2014 do you never tire of the black/white dualist thought? i sure do. a system that calculates values for procedures in terms such as cost per years of life and then has the national discussion on whether that cost is appropriate is a far cry from what you describe. who are the people proposing a "just say no" approach to allocation of health dollars? names please.. on the other hand i feel confident that we can put you down in the column that if you've paid into medicare fully, you should be able to "recoup" unlimited multiples of your premium payments for any procedure at any cost. even the most ardent repugnant con pols know that course is unsustainable even for a few short years but are rarely willing to admit it. returning to the hip replacement (cuz you all just can't seem to grasp any part of the point - perhaps being just a tad less pedantic and literal would help), 750,000 americans per year isn't "never ever" (if you're stuck on spain, please refer to the above suggestions). take a look at this site http://www.allmedica...ip-replacement/ and then tell me that most of these people are looking at experimental treatments. hell, i personally know more than few folks that have done this, had good outcomes and saved enough cash to go on a couple nice real vacations later. That's some funny schit there. You know more than a few people that saved a bunch of cash by spending a bunch of cash overseas?
birdog1960 Posted January 24, 2014 Posted January 24, 2014 (edited) That's some funny schit there. You know more than a few people that saved a bunch of cash by spending a bunch of cash overseas? you truly are dim aren't you. in your case, lets say you're going to get hair replacement and liposuction. you can gewt them both for 2k in thailand or for 10k in des moines. you went to thailand, saved 8 k but unfortunately you're still homely. Edited January 24, 2014 by birdog1960
TakeYouToTasker Posted January 24, 2014 Posted January 24, 2014 you truly are dim aren't you. in your case, lets say you're going to get hair replacement and liposuction. you can gewt them both for 2k in thailand or for 10k in des moines. you went to thailand, saved 8 k but unfortunately you're still homely. What would a personality transplant cost in Thailand? You could certainly use one.
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