Thread: Health Care in the USA

Some people are in favor of a Darwinian society. A survival of the fittest sort of thing. I am not one of them.

Originally Posted by JimmyHAD

Some people are in favor of a Darwinian society. A survival of the fittest sort of thing. I am not one of them.

That about sums up my position after reading all your comments. And the information below to explain why insurance is cheaper per person if everyone has it is going to be my last post for now. I need to step away from the conversation.

As for monopoly being cheaper. Look at your cable bill. Your gas bill, your electric bill, your water bill. Those are all monopolies and are all cheaper because of economies of scale.

However, insurance is not a business. It is a risk spreading device. Your state requires you to have automobile insurance if you drive a vehicle does it not? Well, they are in essence forcing you to do that. Why? Because not only does it protect the person who you may hit, but it protects you from other uninsured people. AND it lowers the cost of your insurance policy because it forces the good drives to pay insurance rates and thereby spread the risk among a larger group of people.

Insurance is a risk management device. It only works at its best if everyone has to participate. Otherwise, only the very risky will opt for insurance. If they can afford it.

the problem with the US health care system, that I can see, has its roots in the Trial Lawyers. A doctor is sued for anything by them, which leads to increase in malpractice insurance for the doctor. In order to not get sued, the doctor runs test for every possible condition, no matter how remote, because they don't want evidence against them that they dropped the ball and did not run a test to find the 1 in 1,000,000 possibility of an extremely rare disease. this leads to endless tests being run when there is no need for them, and an increase in the cost of basic healthcare.

My vote, instead of creating a new department of the Government, appointment of a new "healthcare czar", and taxing the crap out of us for it, HOW ABOUT SOME TORT REFORM???? Limit the law suits against the doctors, and watch their insurance premiums drop (drastically), and then watch the doctors stop running useless tests just to cover their arses, and then watch the cost of healthcare drop, and then watch the cost of insurance drop.

edit: however, the trial lawyers won't let that happen, and the democrats are so in bed with that lobby group that they are conjoined twins.

Edit #2: also, I know from the doctors that I have spoken to, their insurance premiums are way into the 6 figures per year, and you know that this expense is just getting passed through to us, the consumer.

Originally Posted by honedright

And what about those who don't want or need health coverage?

Well in a democratic society it really depends on how many of them there are. All I know so far is that they are less than 10%. That's why I asked the question - how many don't currently buy insurance because they want to pay for all of their health care the same way they pay for say gas and grocery i.e. pay on the spot the cost of what you use.
In the years I have been in US I have paid a little bit more in insurance than I have been billed for medical expenses, so for me it's been more or less a wash. Most people in my socioeconomic and age group that I know seem have only used small fraction 1%-10% of medical services that I have used and few have used few times more than me.

Personally I think having health insurance is the smarter way of doing things than not having one.

Originally Posted by mhailey

HOW ABOUT SOME TORT REFORM???? Limit the law suits against the doctors, and watch their insurance premiums drop (drastically)

What you describe seems to suggest that the problem is not in the lawsuits themselves but in the way they are resolved. It seems that the expectations of doctors making no mistakes whatsoever are very unreasonable.
I don't see how the government imposing limits the way you seem to propose is addressing the problem. I have not thought about this at all, but off the top of my head I think restructuring the awards is a much better way to deal with it. If the patient who was not diagnosed for that extremely rare disease and their lawyer don't get most of the money, but it instead goes into funding more research for that disease?


As far as the arguments that the congress is incompetent of running a health care system, I don't think they are supposed to run it. They are supposed to be good at making policy, not running things and that's what this is about.

At the end of the day the overall numbers are pretty clear, us spends more money than similarly developed countries for much worse results in some areas (like children mortality) and much better in others (treatment of extremely rare and difficult diseases). So to some extent it's a matter of values - what are the types of healthcare that the american society values more. For example it seems that to some of you it's better to die independent than get help that you don't think you have earned. (I wonder what would be the case if it's not your life but the one of your wife/husband/child, i.e. would you choose to not insure them and instead be prepared to face the full consequences of any serious disease and injury.)

Originally Posted by gugi

What you describe seems to suggest that the problem is not in the lawsuits themselves but in the way they are resolved. It seems that the expectations of doctors making no mistakes whatsoever are very unreasonable.
I don't see how the government imposing limits the way you seem to propose is addressing the problem. I have not thought about this at all, but off the top of my head I think restructuring the awards is a much better way to deal with it. If the patient who was not diagnosed for that extremely rare disease and their lawyer don't get most of the money, but it instead goes into funding more research for that disease?

This is what I mean by Tort Reform. Limit the recovery in most circumstances, decrease the statute of limitations, etc. ... .

Originally Posted by gugi

there are plenty of doctors who do not accept any insurance - anybody here used that type of health care?

yep. I buy health insurance... and when I feel like buying better service (or more service) than is provided in my basic plan, I go and buy it, cash in hand.

My health insurance subscription is voluntary. My extra spending on non-essential procedures because I can afford them... is voluntary. I am free to choose.

What if I want to keep buying the insurance that I CHOOSE? seems like the new plan doesn't have room for guys like me. I favor the freest market possible. I favor the most personal choice possible. The fewer decisions the government makes for me, the happier I am.

I'd rather get sick and die then let the government take one more shred of my personal liberty with the excuse that they know what's good for me better than I do.

Some of you feel that no one should have needs that aren't met. You are more than happy to sacrifice liberty for security. There is good news, though... you can get fed, get free health care, and have absolute security in this country. For free. Go rob a bank, and you'll get to go to jail where they feed you and the doctor sees you for free. No liberty, but hey, it was worth it, right?


No thanks. I'd rather keep my liberty and take my chances. A lot of people don't understand that mindset, and I reckon they never will. No amount of talking will every change it. Some people value their liberty more than their lives, and some don't, that's all.

To quote Shakespeare once more, this spirited debate is 'full of sound and fury signifying nothing'. They ain't going to pass health care legislation this time and they probably won't in our lifetimes. I'm going to go hone a razor.

Originally Posted by jockeys

yep. I buy health insurance... and when I feel like buying better service (or more service) than is provided in my basic plan, I go and buy it, cash in hand.

yes, but why buy the health insurance in the first place? why not just pay for the health services you use when you use them again cash in hand.

sounds like you are willing to have the third party between you and the provider for some basic services, but not for others. i understand that everybody's 'basic service' level could be different, but why yours is not at zero. That seems like the simplest form of market with the fewer number of parties involved.

For car insurance the government requires everybody to have a minimum coverage and I guess it requires all the car insurers to provide this level. Seems to me that they want to do something similar to the health insurance where everybody would be required to have some minimum coverage but also the government will be providing this coverage along with the other parties who can also provide that or more.

Originally Posted by jockeys

Some people value their liberty more than their lives, and some don't, that's all.

I'd say most people value their lives more than their liberty and I think this is normal. In fact I'm not sure that the whole liberty and heroism thing isn't a result of mostly propaganda and brainwashing.
That's why the question that I asked was do you value the life of your children more than their liberty. I mean would you rather have them dead than slaves, in practical terms would you kill them if their freedom is threatened and that's the only thing you can do to avoid it?

Originally Posted by gugi

1. i understand that everybody's 'basic service' level could be different, but why yours is not at zero. That seems like the simplest form of market with the fewer number of parties involved.

2. For car insurance the government requires everybody to have a minimum coverage

3. I'd say most people value their lives more than their liberty and I think this is normal.

4. I mean would you rather have them dead than slaves

good questions. please see numbers above.
1. I like the health insurance I choose to buy, which is why I choose to buy it. if I didn't like it, I wouldn't buy it. I'm not opposed to insurance, I'm just opposed to being forced to have it via legislative fiat.
2. red herring. minimum car insurance is not insuring your own car, it's insuring the cars of everyone else against damage you might do to it. you are not required (in my state, anyhow) to insure your own vehicle AT ALL. now, I have a nice truck and I fully insure it. but that's a choice I made on my own, a voluntary investment.
3. it's also "normal" to watch more than 10 hours of tv a week (I watch none), to never use a straight razor, and to listen to Brittney Spears rather than Mozart. Normality isn't necessarily a desirable thing. IMHO, normality is borderline despicable.
4. unhesitatingly yes. It's better to die on your feet than live on your knees. I am fully aware that most people are not so uncompromising. I'm fully aware that faced with such a choice, most people would choose their lives over their principles. I wouldn't.

I spent many years working in the health care system, mostly for health plans. I don't know that there is a solution that will make everyone happy. The big problem we have now - and I don't know that anyone is really focusing on it - is the increasing cost of care. Every year the cost of care -and that includes insurance premiums - goes up three to four times more than inflation. Even if people have insurance, they can't afford it much longer and neither can the employers. Yes, a gov. run system will check costs, but that will reduce provider participation and retard research.

Most of our health care dollars go to treat patients who have chronic conditions (diabetes, COPD, asthma, etc). I do think a certain amount of required participation in disease management programs for them would help. If they don't want to participate, they should have to pay more out of pocket.

End of life decisions are another issue. I've seen a number of cases where say a 90 something year old person goes into a facility. They are on a ventilator, require dialysis, and have other comorbidities. In the jargon, they are referred to as "trainwrecks". They languish for months with no quality of life. Often they have nobody to make decisions for them. This "treatment" costs huge amounts of money for just one person. They slip through the cracks.

Let's also remember that until about 30 years ago, doctors and hospitals had no constraints on what they did and what they got paid for. They played pretty loose with our money. That is why health plans had to begin "interfering" with doctors. The fact is that the people reviewing cases are doctors and nurses who genuinly care about people - I've seen it myself. They are not bureaucrats, and they apply protocols decided on by the various specialty medical societies that represent the treating physicians. The protocols are based on emprical research. If a case requires a unique approach, it can and most likely will be approved.

There's still a lot of waste in the system. I'm rambling so I'll stop now and see if I can be a little more coherent later.

Jordan