Going to the doctor in the US costs you, or an insurance company, or the government, $100 plus.
Going to the doctor in Hong Kong (and many other countries) costs you, or an insurance company, or the government $20-$40.
How do you address that problem?
The poor do not "take advantage of the ER system" or depend on Medicare because they are cheats. They "take advantage of the ER system" or depend on Medicare because without the option of doing so, they can't get any treatment at all. Is that what you want?
Quote:
Originally Posted by Splinemodel
If you're poor and a US citizen, you're probably getting handouts from medicare. If your poor and not a US citizen, you can abuse the ER system.
The system is fucked, but there are more ways to solve it than simply by getting government involved. For example, if ERs were allowed to refuse service to the non-insured (or those who can't pay) for non-life-threatening conditions, that alone would solve a lot of problems. Additionally, the lack of commonality in forms and medical informatics creates a web of confusion that has led to an overly convoluted payment system replete with middlemen. The cost of processing insurance claims is so high, due to this mess, that doctors have to pad their fees. And due to various other laws, they have to charge the same price for services, whether it goes through insurance claims or not. The bottom line is that if you had explained you situation and then handed the doctor $40 cash, you would have gotten the same prescription. It's very likely he also would have given you the medicine, straight up.
Yes, it's a mess. But 90% of the mess could be solved by rewriting a few laws, very slightly, and by mandating a clear standard in medical informatics for processing insurance claims. The first part is conceivably possible, but the second part is unlikely due to graft in washington. The recent bailout highlights this. I don't know too much about McCain's situation, but Obama gets much of his campaign funding from the financial groups that just got bailed out. I presume it's not too much different for McCain. This is all very disconcerting, because even if government were to implement nationalized health care, the major problems would still exist. We'd just be paying for it differently, and almost certainly paying more due to the poor track record the US government has in efficiently running any nationalized program.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
Requiring prior assessment of ability to pay before treatment adds a middle step. As you say, we need to remove middle steps/middle men.
In order to do that we have to balance abuse of the system with simplification of the process. The more abuse-proof the system, the more complex, and hence, more expensive the process needs to be.
This is why I explained the situation in Hong Kong, where you don't have to present any financial documents or immigration documents to get treated. If the US adopted this approach, much red tape could be removed. What you've described suggests adding red tape.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
You're not on my blacklist, Spliney. If I had a blacklist, however, it would include:
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
With regard to "the greater difficulty of getting the degree" in the US, exactly how much, if anything, do you actually know about this, and how much of what you're saying is conjecture?
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
You're partially right but the cost of medical care in the US is more complicated than that.
See the cost of a medical education here. And those are figures for 2005. I'm sure that they've gone up since then.
Look at the costs for malpractice insurance:
While these figures are from 2001, I doubt they've gone down and with losses in the financial markets are likely to go up in the future.
Oh and here are numbers on average nurse's salary in the US here.
While these costs aren't all of the costs incurred to keep a medical office open I throw them out to give you an idea of the costs associated with healthcare in the US. Its not cheap and likely never will be. Consider this. If an internist has 2000 billable patient encounters a year and his insurance cost is $10000 per year, the cost just to cover malpractice insurance alone is $5 per visit. For surgeons and Ob/Gyns the cost is much greater.
Honestly, I laugh when people wonder why they can't go into a doctors office and be seen for $20. They have no clue.
With regard to "the greater difficulty of getting the degree" in the US, exactly how much, if anything, do you actually know about this, and how much of what you're saying is conjecture?
I know a lot of doctors, medical students, and residents in the USA. Some support McCain. Some support Obama. They all tell more or less the same story. I can't point you to an authoritative, written source, but nonetheless I'm confident you'll get the same feedback if you do your own study.
Also (aside), you may want to consider changing "supply-side economists" to "Reaganomics" on your blacklist. I don't think there's such thing as an economist, these days, who doesn't see value in supply-side economics per se. Reaganomics is more specific to the trickle-down approach.
I know a lot of doctors, medical students, and residents in the USA. Some support McCain. Some support Obama. They all tell more or less the same story. I can't point you to an authoritative, written source, but nonetheless I'm confident you'll get the same feedback if you do your own study.
So you're listening to a one-sided story, or have all of these doctors, students and residents studied medicine overseas as well, so they have something to compare their experience to?
What you originally claimed is not that getting a medical degree and a position is teh hard™ but that it is harder in the US than it is in other countries, leading to higher medical costs, aside from insurance and operating overhead. What I'm asking is for you to tell me where you got that idea (that it is harder in the US than it is in other countries). Instead you say you've heard stories that it is teh hard™.
Quote:
Also (aside), you may want to consider changing "supply-side economists" to "Reaganomics" on your blacklist. I don't think there's such thing as an economist, these days, who doesn't see value in supply-side economics per se. Reaganomics is more specific to the trickle-down approach.
You've lost me there... supply-side is the "trickle down" approach, and yes it is a part of an economic policy that is necessary. By "supply-side economist", it's clear that I'm referring to people who think that supply-side should be the main part (or the only part) of the economic approach, and people who believe that demand-side policies should be avoided.
It's pretty lame how standard of living issues frequently just turn into debates about health care systems. It's really just one issue among many and there are a variety of health care systems to choose from when choosing to settle in any of the increasing number of places with a higher standard of living than even the best parts of the US.
The biggest issue, IMO, is the double taxation on earnings over $85K that the US forces on citizens living abroad. Fuck that shit.
I think the sooner the world realizes that poor people (Mac Mini's), middle class lower and upper (MacBooks and iMac's), and rich people (MBP and MP), exist and will always exist, life would be better.
That and we need to ship all the lawyers to the sun in a space shuttle with one way tickets. Which would effectively do away with all politicians.
Of course that's not the cost. That's how much the patient pays at the office. Much more is paid via taxes for health care under a government controlled system.
Would it really hurt Americans to stop looking at either themselves in the mirror or cartoons of what the "Rest of the World" is like?
Lots of valuable lessons can be learnt by seriously studying numerous experiments in public policy, and their results around the world.
Given what America has got now, thinking outside of the box has to be a good thing.
WOW more reason to vote against Hussein Obama. If all the liberals would leave the country [or better yet...the planet] we could fix everything the Democrat controlled congress has screwed up!!
WOW more reason to vote against Hussein Obama. If all the liberals would leave the country [or better yet...the planet] we could fix everything the Democrat controlled congress has screwed up!!
Yeah! Back to the way everything was during the previous 6 years! That rocked!
To all of you that say you would leave the country if Mc Cain won, I say save us the trouble of dealing with you now and leave. If your patriatism extends to who is in office, your not really an American anyway.
So GTFO now and stop taking up my free air and free speech.
Goto another country that allows you to say whatever you like about the current authorities without worry of reproach, harassment or retribution.
But thats right, you wouldnt leave even if we had voted Hitler in, because you know that if you moved out of OUR country (I capitalized that to show its not really yours) you wouldnt make it but a few months or years before you mouth got you in a jail or worse.
I guess thats the greatness behind our country is the ablility to freely speak our minds, isnt it. Just dont make threats you dont truly plan to keep.
Comments
Going to the doctor in the US costs you, or an insurance company, or the government, $100 plus.
Going to the doctor in Hong Kong (and many other countries) costs you, or an insurance company, or the government $20-$40.
How do you address that problem?
The poor do not "take advantage of the ER system" or depend on Medicare because they are cheats. They "take advantage of the ER system" or depend on Medicare because without the option of doing so, they can't get any treatment at all. Is that what you want?
If you're poor and a US citizen, you're probably getting handouts from medicare. If your poor and not a US citizen, you can abuse the ER system.
The system is fucked, but there are more ways to solve it than simply by getting government involved. For example, if ERs were allowed to refuse service to the non-insured (or those who can't pay) for non-life-threatening conditions, that alone would solve a lot of problems. Additionally, the lack of commonality in forms and medical informatics creates a web of confusion that has led to an overly convoluted payment system replete with middlemen. The cost of processing insurance claims is so high, due to this mess, that doctors have to pad their fees. And due to various other laws, they have to charge the same price for services, whether it goes through insurance claims or not. The bottom line is that if you had explained you situation and then handed the doctor $40 cash, you would have gotten the same prescription. It's very likely he also would have given you the medicine, straight up.
Yes, it's a mess. But 90% of the mess could be solved by rewriting a few laws, very slightly, and by mandating a clear standard in medical informatics for processing insurance claims. The first part is conceivably possible, but the second part is unlikely due to graft in washington. The recent bailout highlights this. I don't know too much about McCain's situation, but Obama gets much of his campaign funding from the financial groups that just got bailed out. I presume it's not too much different for McCain. This is all very disconcerting, because even if government were to implement nationalized health care, the major problems would still exist. We'd just be paying for it differently, and almost certainly paying more due to the poor track record the US government has in efficiently running any nationalized program.
WHOOSH! Over the head. Missed my entire point.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
Requiring prior assessment of ability to pay before treatment adds a middle step. As you say, we need to remove middle steps/middle men.
In order to do that we have to balance abuse of the system with simplification of the process. The more abuse-proof the system, the more complex, and hence, more expensive the process needs to be.
This is why I explained the situation in Hong Kong, where you don't have to present any financial documents or immigration documents to get treated. If the US adopted this approach, much red tape could be removed. What you've described suggests adding red tape.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
You're not on my blacklist, Spliney. If I had a blacklist, however, it would include:
1) Single issue voters.
2) Theocrats.
3) War hawks.
4) Supply-side economists.
5) Those who blame the poor for being poor.
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
With regard to "the greater difficulty of getting the degree" in the US, exactly how much, if anything, do you actually know about this, and how much of what you're saying is conjecture?
Actually, I understand your entire point completely, and I addressed all of your concerns. I will reduce to soundbites and reiterate:
-The high costs are largely wrapped up in middlemen.
-The poor in general don't abuse ERs, illegal immigrants do. There are systems in place for american poor, which I also mentioned in the post (first sentence, in fact).
I know I'm on your black list because I don't like The One, but the post is about as objective as gets for AO/PO. While I'm at it, I'll also mention that the higher price of US doctor visits, in comparison with HK visits, I bet you're not reading this, is also affected by the greater difficulty in getting the degree, here. Hence there are fewer doctors, hence higher cost. Supply and demand. But the real driver is the mess that is the insurance system, and because of graft in washington, it's unlikely that this will be solved by nationalizing healthcare.
You're partially right but the cost of medical care in the US is more complicated than that.
See the cost of a medical education here. And those are figures for 2005. I'm sure that they've gone up since then.
Look at the costs for malpractice insurance:
While these figures are from 2001, I doubt they've gone down and with losses in the financial markets are likely to go up in the future.
Oh and here are numbers on average nurse's salary in the US here.
While these costs aren't all of the costs incurred to keep a medical office open I throw them out to give you an idea of the costs associated with healthcare in the US. Its not cheap and likely never will be. Consider this. If an internist has 2000 billable patient encounters a year and his insurance cost is $10000 per year, the cost just to cover malpractice insurance alone is $5 per visit. For surgeons and Ob/Gyns the cost is much greater.
Honestly, I laugh when people wonder why they can't go into a doctors office and be seen for $20. They have no clue.
With regard to "the greater difficulty of getting the degree" in the US, exactly how much, if anything, do you actually know about this, and how much of what you're saying is conjecture?
I know a lot of doctors, medical students, and residents in the USA. Some support McCain. Some support Obama. They all tell more or less the same story. I can't point you to an authoritative, written source, but nonetheless I'm confident you'll get the same feedback if you do your own study.
Also (aside), you may want to consider changing "supply-side economists" to "Reaganomics" on your blacklist. I don't think there's such thing as an economist, these days, who doesn't see value in supply-side economics per se. Reaganomics is more specific to the trickle-down approach.
I know a lot of doctors, medical students, and residents in the USA. Some support McCain. Some support Obama. They all tell more or less the same story. I can't point you to an authoritative, written source, but nonetheless I'm confident you'll get the same feedback if you do your own study.
So you're listening to a one-sided story, or have all of these doctors, students and residents studied medicine overseas as well, so they have something to compare their experience to?
What you originally claimed is not that getting a medical degree and a position is teh hard™ but that it is harder in the US than it is in other countries, leading to higher medical costs, aside from insurance and operating overhead. What I'm asking is for you to tell me where you got that idea (that it is harder in the US than it is in other countries). Instead you say you've heard stories that it is teh hard™.
Also (aside), you may want to consider changing "supply-side economists" to "Reaganomics" on your blacklist. I don't think there's such thing as an economist, these days, who doesn't see value in supply-side economics per se. Reaganomics is more specific to the trickle-down approach.
You've lost me there... supply-side is the "trickle down" approach, and yes it is a part of an economic policy that is necessary. By "supply-side economist", it's clear that I'm referring to people who think that supply-side should be the main part (or the only part) of the economic approach, and people who believe that demand-side policies should be avoided.
The biggest issue, IMO, is the double taxation on earnings over $85K that the US forces on citizens living abroad. Fuck that shit.
Better healthcare, cleaner air, better education, better public transport...
Hey. Maybe there's something in this 'taxes'...
LOL! Hey, live your life. Just don't expect to find better than California girls in Europe.
That and we need to ship all the lawyers to the sun in a space shuttle with one way tickets. Which would effectively do away with all politicians.
How many would leave if Palin took over if McCain buys the farm?
You don't want to go there...
Of course that's not the cost. That's how much the patient pays at the office. Much more is paid via taxes for health care under a government controlled system.
Would it really hurt Americans to stop looking at either themselves in the mirror or cartoons of what the "Rest of the World" is like?
Lots of valuable lessons can be learnt by seriously studying numerous experiments in public policy, and their results around the world.
Given what America has got now, thinking outside of the box has to be a good thing.
You don't want to go there...
Whatever you do, DON'T CLICK THE RED PHONE!
Tina Fey: If McCain/Palin wins, I'm leaving the planet.
Man, I'm almost starting to hope that Obama wins now. I think there are going to be riots, mass suicides, etc. if McCain wins.
WOW more reason to vote against Hussein Obama. If all the liberals would leave the country [or better yet...the planet] we could fix everything the Democrat controlled congress has screwed up!!
Yeah! Back to the way everything was during the previous 6 years! That rocked!
So GTFO now and stop taking up my free air and free speech.
Goto another country that allows you to say whatever you like about the current authorities without worry of reproach, harassment or retribution.
But thats right, you wouldnt leave even if we had voted Hitler in, because you know that if you moved out of OUR country (I capitalized that to show its not really yours) you wouldnt make it but a few months or years before you mouth got you in a jail or worse.
I guess thats the greatness behind our country is the ablility to freely speak our minds, isnt it. Just dont make threats you dont truly plan to keep.