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Every horrible thing you ever heard about the health insurance industry is true

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  • #46
    Re: Every horrible thing you ever heard about the health insurance industry is true

    I stitched up a pretty complex thumb laceration today including assessing the underlying potential for nerve and joint injury. The bill was $83.10 AUD, and the cost to the patient was $17. Just thought I would point this out given the debate going on about relative costs of health care - australia has a single payer system for the vast majority of transactions. I'm pretty sure doctors would be worse off over here, but I think the odds are funds would be much more efficiently distributed. Seriously, the rest of the developed world looks at the US health system and thinks, "there but for the grace of God...". Yes, this means taxes have to pay for health care, but the percentage of GDP spent on health is (as far as I know) universally lower for a publicly funded system. We have a combination, where government funds everyone, wealthier people pay a higher taxation levy, private practice doctors have discretion to charge what seems reasonable (and the market will bear) above the government rebate, and those who want to pay for private insurance are free to do so.

    Not directed at you flintlock, just because you mentioned the cost of health care to your child.

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    • #47
      Re: Every horrible thing you ever heard about the health insurance industry is true

      From experience (I am an FMP in Australia) the people who most need to seek health care won't pay the doctor, or more accurately they simply won't come if they need to pay. Lifestyle diseases like diabetes, heart disease and smoking are the most serious epidemics in the developed world. The people most at risk of these diseases are usually not those who willingly pay to visit the doctor, although they usually have enough money for cigarettes and Mars bars. The problem with lifestyle diseases is they have no symptoms. If high blood pressure was incredibly painful, people would be queing up to have it treated. Because these problems sit in the background quietly killing people over years, public health promotion needs to be publicly funded, or it will be likely to be ignored. I've known colleagues who tried charging this group of patients $20 AUD above the medicare rebate, and they stopped visiting. Fantastic for him as an FMP - wealthier patients, less complex problems, no bad debts - but not so marvellous for the public welfare, as some of them will go on to have devastating (and highly expensive) cardiac events, which might have been delayed to old age if they were properly treated.

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      • #48
        Re: Every horrible thing you ever heard about the health insurance industry is true

        Originally posted by cjppjc View Post
        I'm sure he did. Most bankruptcy lawers back in the day would tell their clients to run up the cards and "then we'll file next month."

        I was a bit confused by this exchange at first too, then I realized you were making a point.

        I can understand JK's point about walking away from an underwater mortgage, but my gripe is with those who run up the HELOC, credit cards, etc and then walk. That's strategic theft in my opinion. People are expected to act in good faith in these contracts. Not that the banks always do.

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        • #49
          Re: Every horrible thing you ever heard about the health insurance industry is true

          Originally posted by KangarooDan View Post
          I stitched up a pretty complex thumb laceration today including assessing the underlying potential for nerve and joint injury. The bill was $83.10 AUD, and the cost to the patient was $17. Just thought I would point this out given the debate going on about relative costs of health care - australia has a single payer system for the vast majority of transactions. I'm pretty sure doctors would be worse off over here, but I think the odds are funds would be much more efficiently distributed. Seriously, the rest of the developed world looks at the US health system and thinks, "there but for the grace of God...". Yes, this means taxes have to pay for health care, but the percentage of GDP spent on health is (as far as I know) universally lower for a publicly funded system. We have a combination, where government funds everyone, wealthier people pay a higher taxation levy, private practice doctors have discretion to charge what seems reasonable (and the market will bear) above the government rebate, and those who want to pay for private insurance are free to do so.

          Not directed at you flintlock, just because you mentioned the cost of health care to your child.
          Thanks for your thoughtful reply. I really value opinions like yours from other parts of the world. The more I hear about health care in other countries, the more I think we should simply study the more successful plans and try to emulate these instead of redesigning things from the ground up.

          I think the wool has been pulled over the eyes of Americans in regard to the real consequences of national health plans. Some of the lies have been repeated so much that nobody even questions them, as the whistle blower in that video described.

          Any serious attempt at health care reform in the US has a uphill battle against it. Not only the current drug companies, hospitals, insurance establishment, but the lawyers who could lose out if they find themselves unable to sue the government. Torts, that's probably the single biggest obstacle that we in the US face than other countries don't. Its big business here, and it dominates how we are forced to do things here. Physicians and hospitals are so worried about getting sued they tend to over do everything. Big part of the high costs.

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          • #50
            Re: Every horrible thing you ever heard about the health insurance industry is true

            Exactly. And then the government has to pay for their hospitalization, disability payments, and food stamps for any dependents. Which is cheaper? Prevention or lifetime disability support? Even if they die, any dependents must be supported. But they often live, albeit with stroke damage or other problems that prevent them working and paying into any system.

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            • #51
              Re: Every horrible thing you ever heard about the health insurance industry is true

              Originally posted by flintlock View Post
              Not that the banks always do.
              Exactly, the banks also share a large portion of the responsability for unpaid loans. It should not only be the debtor at fault.

              Too bad that our governments is so inclined in making whole only one party.

              Hence, I think that is where jk is coming from: if it is a mortgage and you are underwater, then given the situation (i.e. government using your taxes to make the banking system whole), yes I agree, walking away could be acceptable.

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              • #52
                Re: Every horrible thing you ever heard about the health insurance industry is true

                Originally posted by LargoWinch View Post
                Exactly, the banks also share a large portion of the responsability for unpaid loans. It should not only be the debtor at fault.

                Too bad that our governments is so inclined in making whole only one party.

                Hence, I think that is where jk is coming from: if it is a mortgage and you are underwater, then given the situation (i.e. government using your taxes to make the banking system whole), yes I agree, walking away could be acceptable.
                I agree with that.

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                • #53
                  Why we can't afford health care. . .

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                  • #54
                    Re: Why we can't afford health care. . .

                    Great post. I think the U.S. has an excellent military, populated by many honorable and patriotic people.

                    But the real question is, can we afford it? Most Americans don't realize what a drain it is on the domestic economy. While a huge amount of U.S. taxes are used to police the world, the rest of world moves ahead of the U.S., in terms of true productive capacity.

                    The military-industrial complex (i.e. military contractors) are the real winners in this, not the average American citizen nor members of the armed services. They make all the money.

                    Like Britain, someday (sooner than most think), we will have to scale back the military. Hopefully we'll do so, before we're too broke to sustain a viable domestic , non-military productive economy.

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                    • #55
                      Re: Every horrible thing you ever heard about the health insurance industry is true

                      Originally posted by flintlock View Post
                      I was a bit confused by this exchange at first too, then I realized you were making a point.

                      I can understand JK's point about walking away from an underwater mortgage, but my gripe is with those who run up the HELOC, credit cards, etc and then walk. That's strategic theft in my opinion. People are expected to act in good faith in these contracts. Not that the banks always do.
                      Usually a HELOC and credit cards will follow you if you walk. I.e., the non-recourse part is only for the principle mortgage. I would also refer you to the concept of the efficient breach if you are not familiar.

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                      • #56
                        Re: Every horrible thing you ever heard about the health insurance industry is true

                        Hasn't widespread availability of Company provided health-care - combined with more and more Government mandated exams driven the price of health-care. If most people had Insurance coverage that kicked in after say $5000 - wouldn't doctors be forced to lower prices for procedures. Shouldn't Insurance be reserved for life and death emergencies. Yes - there will be many that will need to find family or friends or community groups to help with this first $5,000 in Medical Bills. When there is lots of Money available - don't prices Rise to meet the Availability of Cash or Credit or Insurance.

                        Also - there would be much less opportunity for Specialist to make a killing. Specialist be involved when it was truly necessary and life saving.

                        I always think of what has happened to Dentist prices since Dental Insurance. My Dad paid cash for all of our dental work - there were six kids and Dad lived pay-check to pay check. This was during the 1970s - and it would be impossible for a father of six to do this today.

                        Am I way off in my assumptions?

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                        • #57
                          Re: Every horrible thing you ever heard about the health insurance industry is true

                          Originally posted by BK View Post
                          Hasn't widespread availability of Company provided health-care - combined with more and more Government mandated exams driven the price of health-care. If most people had Insurance coverage that kicked in after say $5000 - wouldn't doctors be forced to lower prices for procedures. Shouldn't Insurance be reserved for life and death emergencies. Yes - there will be many that will need to find family or friends or community groups to help with this first $5,000 in Medical Bills. When there is lots of Money available - don't prices Rise to meet the Availability of Cash or Credit or Insurance.

                          Also - there would be much less opportunity for Specialist to make a killing. Specialist be involved when it was truly necessary and life saving.

                          I always think of what has happened to Dentist prices since Dental Insurance. My Dad paid cash for all of our dental work - there were six kids and Dad lived pay-check to pay check. This was during the 1970s - and it would be impossible for a father of six to do this today.

                          Am I way off in my assumptions?
                          I was always on board 100% with the high deductible idea of self insuring for smaller medical expenses. That's really how insurance should work. Unfortunately, many high deductible policies now also offer only a 70/30 co-pay after the deductible is met. The max out of pocket limit has also been creeping up. Pretty soon you are looking at serious money if you have a family where more than one person gets seriously ill in the same year. I can see why more are choosing to "go neked" as they call it.

                          Actually, chronic conditions can end up costing more than "life and death" situations in some cases. While not as dramatic, a chronic illness can be just as devastating as say, a heat attack. And worse, they can go on for years, with the patient paying out more money in the long run than say for example, a major operation.

                          I think something needs to be done to make the whole process more streamlined and efficient. Cost are out of hand any way you slice it. I'm not really sure how to go about it but I bet there are some in the industry who could come up with a solution.

                          As far as Dentists, I read somewhere that the number of dental schools has shrunken , limiting the number of new dentists coming into the market. I have no idea if that is true or not. And no, a working class father of even one can hardly afford to pay out of pocket these days. But that may have more to do with wages than costs.

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                          • #58
                            Re: Every horrible thing you ever heard about the health insurance industry is true

                            Originally posted by jdv
                            the reality is that most of the time they are not gouging as much as popular belief would indicate.
                            Premiums are a small part of the game, you have to understand leverage to understand insurance pricing.

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                            • #59
                              Re: Every horrible thing you ever heard about the health insurance industry is true

                              Originally posted by Roughneck View Post
                              When was the last time amtrack turned a profit?
                              I don't believe any rail system anywhere in the world runs a profit.

                              On the other hand I don't think our system of securing oil (bloated military) or our federal highway system are particularly profitable enterprises.

                              Infrastructure may not be profitable on its own, but when you take it away you start to realize it was necessary for profit to be made elsewhere.

                              The Boston MBTA is not profitable, but Boston would cease to function due to gridlock without it.

                              Come to think of it I don't know of any schools that run a profit. Perhaps we should shut them down as well !?

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                              • #60
                                Re: Every horrible thing you ever heard about the health insurance industry is true

                                Insurance Won't Pay NorCal Mom's Cancer Treatment

                                Will your insurance company pay for the treatment your doctors recommend? They may not. That's what a single mother from Chico said she found out.


                                In late April, Shelly Andrews-Buta was scheduled to undergo treatment for breast cancer that had spread to her brain, threatening her life.

                                The experience has been emotionally devastating. "I have two beautiful children, you know, I'm a single mom, they need me to be around," Andrews-Buta told CBS 5 Investigates.

                                But instead of having doctors working to remove her brain tumors on the day the surgery was scheduled, she sat in a San Francisco hotel room. Why? Because at the last minute, her insurance company, Blue Shield, decided it wasn't going to pay for the treatment her doctors at UCSF Medical Center had recommended.
                                Full story here.

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