Single Payer Universal Health Care



Ted Rosenberg <[email protected]> wrote in message news:<[email protected]>...
> One of the problems of the health care system is that it
> is not even vaguely a free market.

Much depends on how you define the market - if you believe
it to be patients then you are probably right - if you
believe it to be providers and payers, it has a lot of the
attributes of an open market.

> Most health care providers will not provide prices for
> comparison shopping, and, if they do say anything, it is
> usually false. They are also not consistent.

Not when they are negotiating fees with payers.

> I helped my wife do research a few years ago for an
> article about the difficulties of health care shopping. It
> was on one simple test, most hospitals flatly refused to
> quote a cost "it's covered by your insurance" "come in,
> have the test, and THEN we will discuss payment".
>
> Two hospitals just flatly lied "we can't quote because we
> don't know how much dye the test will use for each
> individual " (NONE, the test doesn't use dye). The
> remainder quoted prices ranging from $200 to $1,800, of
> course, for insurance companies, it would be about $120
> from all of them !!!

The overwhelming majority of purchases for inpatient
services are made by payers, not patients. The transparency
in prices is at that level.

> When the article ran, she got indignant letters from
> hospitals, but fan mail from doctors. They hadn't had a
> CLUE that prices varied from place to place.

Not place to place - within place and between customer
segments.

> I am also battling a hospital at the moment, I need a
> regular blood test to adjust dosage of some meds. The
> hospital quoted me $37/visit, - fair enough price, even if
> insurance companies would only pay $25. BUT, they BILLED
> amounts ranging from $42.20 to $53.45, when asked why, I
> get a different answer every time I call (on the SAME
> bill) and they are annoyed that I won't pay them until
> they get the bill straightened. And tell me to call the
> doctor - there IS no doctor!. When I ask the
> pharmacologist at the lab, SHE says "that isn't right, you
> should call billing"

Who ordered the test? Did you get the quote in writing? Send
them a check for $37 and tell them to sue you for the rest.

You have every right to negotiate a price with any provider
for any service.

js
 
"dahmd" <[email protected]> wrote in message news:<[email protected]>...
> "Jonathan Smith" <[email protected]> wrote in
> message
> news:[email protected]...
> > mike gray <[email protected]> wrote in message
> news:<tLIsc.26690$fF3.685017@bgtnsc05-
> news.ops.worldnet.att.net>...
> > > matt weber wrote:
> > >
> > > > Because in the USA, someone other than the patient
> > > > usually pays, and patient is almost entirely
> > > > isolated from the cost issue, as is the physician,
> > > > when a patient walks in and says my shoulder is
> > > > bothering me, can you write me a prescription for
> > > > Celebrex or Viox? The physician will happily do so.
> >
> > Why is this necessarily a bad thing? Under the
> > assumption that there is a doctor-patient relationship
> > and the physician does an exam to look for something
> > other than muscle or joint pain due to exertion or
> > perhaps a touch of arthritis, thuis makes a lot of
> > sense. What would you do in this case?
> >
> > > That is, indeed, a major problem with the US system
> > > and I'll give you another example. I sprained my
> > > wrist, went to the corner dugstore and bought an Ace
> > > bandage. $3 and it was fine in five weeks. My Medicare
> > > friend sprained his wrist, went to the ER, X-rays,
> > > orthopedic specialist, and seven weeks of physical
> > > therapy even though it was fine in five weeks.
> >
> > And Medicare would be that huge efficient single payer
> > model that we all want and need?
> >
> > > But "rationing" has become a buzzword in the US
> > > roughly as evil as "holocaust". An insured patient who
> > > goes to a doctor with a sprained wrist and gets only
> > > an Ace bandage will certainly sue and just as
> > > certainly win.
> >
> > If the sprain wasn't a sprain and the failure to
> > diagnose results in a permanent disability - yes, that
> > is what would happen. Explain to me why it shouldn't.
> >
> > > This has created another problem: US doctors are
> > > scared to death of their own patients. Very unhealthy
> > > situation.
> >
> > I don't believe they are - they may be a bit
> > apprehensive over their patients lawyers - so lets
> > fix that.
> >
> > js
> >
>
> I have enjoyed reading your comments. It's much more
> pleasant debating issues without vitriol.

Thanks - and I play the violin, not the vitriol - but I
could learn.

> Unfortunately, as on obstetrician I see dozens of examples
> every day where physicians are so afraid of litigation
> that they either refuse to see pregnant patients or, if
> they practice ob/gyn, refuse to see "high risk" pregnant
> patients. In the last 2 years the number of ob/gyn
> physicians in our metropolitan area (Orlando; about 2
> million in surrounding communities) who are willing to see
> high risk pregnant patients has dwindled dramatically.
> Several of our top ob/gyns have left the area rather than
> risk becoming part of the liability crisis, and many
> others have given up obstetrics. In Dade County (Miami)
> the median liability premium for those practicing
> obstetrics is about $200,000 a year. Physicians in other
> specialties just don't want to be exposed to those kind of
> premiums.

No question that liability in the practice of medicine and
the necessary insurance to mitigate the downside risk is at
a critical point. I can understand and appreciate it - but
this is not driven by patients - it is driven by lawyers
interested in settlements and patients convinced that its
easy money and they are entitled to it.

> I spoke with several physicians from various specialties
> in the OR lounge today who made it clear that they will do
> anything rather than treat a pregnant patient. The statute
> of limitations for a newborn can be up to 21 years in
> Florida, and there are several hundred ads on TV and the
> radio in our area each week advising locals to sue their
> physician. One series of ads suggested that ob/gyns don't
> perform c/sections in a timely manner, leading to brain
> damage. I would love to study the c/section rate before
> and after that series of ads. I am awaiting the results of
> a recent mail-in survey to read hard data, but in the
> meantime, at least in Florida, fear of litigation has had
> a negative impact on the availability of services and
> quality of care for pregnant patients. Pregnant patients
> can provide a lottery win for trial lawyers. It's to the
> stage where physicians feel their careers are at risk when
> they care for pregnant women. Best wishes,

Fortunately, I do not treat patients as I am retired. Most
of my career was outside of direct patient care though I do,
to this day, carry professional liability insurance myself -
not at the same cost as medical malpractice insurance, but
still quite expensive (more than my health care insurance).

js
 
"George Conklin" <[email protected]> wrote in message
news:[email protected]...
|| > | >
| > | > Read past posts again, slowly, for
| > | > comprehension.....
| > | >
| > | > Medicine is more expensive here because it is BETTER
| > |
| > | Ah, the big lie. Based on results, it is #38 in the
| > | world. But
then
| > | again I guess you think WHO is just a bunch of
| > | commies.
| >
| > No, but the WHO is run by the UN - a gaggle of third
| > raters without a
| moral
| > center. I wouldn't believe anything they say.
| >
| > Just for fun, how do they manage to rate us #38? What
| > are the criteria?
| Who
| > are the 37 that are better?
| >
| > PC
| >
|
| I knew you were going to reject anything but your own
| opinions, based
on
| moral centers, not medical outcomes. Ayn Rand was the most
| harmful pseudo-intellectual who every lived here.

I "rejected" nothing - I asked you to answer a few fact
based questions. It's interesting to note that you
can't/won't and went right back to bashing others.....:)

Quit while you're behind....:)

PC
 
"Jonathan Smith" <[email protected]> wrote in message
news:[email protected]...
| "Proconsul" <[email protected]> wrote in message
news:<fITsc.32692$PU5.9534@fed1read06>...
| > "George Conklin" <[email protected]> wrote in
| > message news:[email protected]
| > thlink.net...
| > |
|| > |
| > | Our outcomes make us about #38. That is a lot of
| > | money for so-so
| > medical
| > | outcomes.
| >
| > Our "outcome", as you put it, puts us way ahead of
| > anyone else - and, to quote someone who said it first,
| > you get what you pay for......until the costs are
| > escalated to pay for things that are merely
| > administrivia
and/or
| > that transfer wealth from one group to another.....
| >
| > | And don't start in that we have the world's worst
| > | patients, and
refrain
| > | from racist comments too.
| >
| > I've made no such comments - is that all you can add to
| > the discussion?
Can
| > you comment rationally on what I and others have said
| > and give us the benefit of your "take" on the subject
| > at hand?
| >
| > PC
|
|
| PC: Georgy has been around for a while. He has never added
| anything of
value.
| http://www.nccu.edu/artsci/social/conklin.htm I'm inclined
| to take Skeptics advice and just ignore him.

Yup - that's clear....:) Good advice in re ignoring him -
it's much like trying to teach a pig to sing....it
frustrates you and pisses off the pig!.....:)

PC

|
| js
 
"George Conklin" <[email protected]> wrote in message
news:[email protected]...
|
| "Proconsul" <[email protected]> wrote in message
| news:fITsc.32692$PU5.9534@fed1read06...
| > | And don't start in that we have the world's worst
| > | patients, and
| refrain
| > | from racist comments too.
| >
| > I've made no such comments - is that all you can add to
| > the discussion?
| Can
| > you comment rationally on what I and others have said
| > and give us the benefit of your "take" on the subject
| > at hand?
| >
| > PC
| >
| >
| I know the Ayn Rand rant.

You haven't a clue - and you simply can't support your take
on matters at hand. You cannot add anything rational to the
discussion.....:)

PC
 
"mike gray" <[email protected]> wrote in message
news:[email protected]...
| Proconsul wrote:
|
| > Total privatization and a competitive free market would
| > accomplish all
you
| > propose and more at lower costs - and would deliver a
| > higher quality of
care
| > for everyone.....
|
| Perhaps. But I can't imagine a health system offering
| access to all without substantial gov't involvement.
| Indeed, the present system of Medicare uses the private
| sector to administer benefits and provide services.

I would refer you to Chile, where their "social security"
system was TOTALLY privatized resulting in folks receive
four to five times the benefits previously paid out by a
government system much like outs. The analogy to medical
care is obvious....

There is NOTHING that the private sector cannot do better
and cheaper than government - except provide for the common
defense and I'm beginning to wonder about that, too!....:)

PC
 
"Proconsul" <[email protected]> wrote in message
news:Sc5tc.35517$PU5.31754@fed1read06...
>
> "mike gray" <[email protected]> wrote in message news:wW2tc.71616$hH.1283895@bgtnsc04-
> news.ops.worldnet.att.net...
> | Proconsul wrote:
> |
> | > Total privatization and a competitive free market
> | > would accomplish all
> you
> | > propose and more at lower costs - and would deliver a
> | > higher quality
of
> care
> | > for everyone.....
> |
> | Perhaps. But I can't imagine a health system offering
> | access to all without substantial gov't involvement.
> | Indeed, the present system of Medicare uses the private
> | sector to administer benefits and provide services.
>
> I would refer you to Chile, where their "social security"
> system was
TOTALLY
> privatized resulting in folks receive four to five times
> the benefits previously paid out by a government system
> much like outs. The analogy to medical care is obvious....
>
> There is NOTHING that the private sector cannot do better
> and cheaper than government - except provide for the
> common defense and I'm beginning to wonder about that,
> too!....:)
>
> PC
>
>

They have a similar system in Galveston, Texas. Many rich
retirees because of it.

--
Brooks Gregory
 
Jonathan Smith <[email protected]> wrote on 26 May 2004 07:07:02
-0700:
> Alan Mackenzie <[email protected]> wrote in message
> news:<[email protected]>...
>> Jonathan Smith <[email protected]> wrote on 25
>> May 2004
>> 13:26:16 -0700:
>> > Alan Mackenzie <[email protected]> wrote in message
>> > news:<[email protected]>...
>> >> Jonathan Smith <[email protected]> wrote on 24
>> >> May 2004
>> >> 19:24:20 -0700:
>> >> > [email protected] wrote in message
>> >> > news:<[email protected]>...
>> >> >> In alt.cancer.support Evelyn Ruut <mama-
>> >> >> [email protected]> wrote:
>> >> >> > Make a single payer universal health care system
>> >> >> > and all the prices will go down.

>> >> >> There is NO free lunch. Name a 'single payer'
>> >> >> system that doesn't have shortages and long delays
>> >> >> for complex treatments such as surgery, etc.

>> >> > I'd even be impressed if she could name one where
>> >> > there isn't a waiting list for simple things like
>> >> > diagnostic xrays and specialist referrals.

>> >> Funny, that. Last Monday (8 days ago), I fell off my
>> >> bike and landed heavily on my ribs. Last Tuesday, on
>> >> waking up, the pain was still significantly above what
>> >> wasn't worrying, so I visited my Doc. He said, better
>> >> get those ribs (and left-hand middle finger) X-rayed.
>> >> I was back in that Doc's surgery little more than an
>> >> hour later, carrying an enveloppe with the requisite
>> >> X-rays. Luckily, nothing was broken.

>> What does "single payer system" mean?

> One payer - typically the central government - for all
> medical services.

OK.

>> > It is a employer mandated insurance system funded by
>> > employer contributions through a system of private (quasi-
>> > private) insurance carriers (Krankenkasse) and
>> > delivered through a primarily private delivery system
>> > on a fee for service or local budget (depending on
>> > provider type) basis.

>> >> health insurance through the "Krankenkassen" is
>> >> compulsory for people earning less that a fairly high
>> >> threshold (around 4,000 Euros/month). The premium paid
>> >> depends only on one's income, and is around 14% of
>> >> salary (with a maximum corresponding to that ~4,000
>> >> Euro threshold), half of it being paid by the
>> >> employer.

>> > It is an employment tax - on the employer. The 7%
>> > metric is one of convenience for accounting. There is
>> > an upper limit - the most you will pay is 250 Euro per
>> > month. If your earnings are under 1000 Euro or so a
>> > month, you get a subsidy.

It's a tax on both parties.

>> >> The unemployed and poor are not excluded. This system
>> >> works very well, despite the recognised inefficiencies
>> >> and, to some extent, corruption.

>> > The system works well BECAUSE it is NOT single payer.
>> > In the US, the poor are not excluded. The unemployed
>> > are not excluded either - there is COBRA.

>> Who is/would be the "single payer" in the US?

> There is a system of care financing provided to the
> elderly called Medicare. Tis is the closest model of
> single payer in the US.

What I don't see is why it makes an enormous difference
whether there is a single payer, or several parallel payers.
Surely the principles governing the collecting of
contributions and providing the services is more important
than whether there's a single government agency, or 20 funds
in parallel (much as in Germany at the moment).

>> >> High earners may stay in the normal Krankenkassen
>> >> insurance scheme, or they may opt for private
>> >> insurance, or even decide to pay for treatment as they
>> >> need it. Having opted out of the Krankenkassen, they
>> >> may not later rejoin them, since the Krankenkassen
>> >> operate on the basis of people "overpaying" when young
>> >> and healthy and "being subsidised" later in life when
>> >> no longer so healthy.

>> > No, that is not exactly true.

>> How not? Apart from people opting out, it is
>> entirely true.

> The premiums paid are based on income and age at
> enrollment. It is not a medical savings account.

No. If we're still talking about Germany, the contributions
are dependent only on current income. It's much more like a
tax than an insurance. The unemployed paid nothing, (or very
close to nothing, I'm not sure). Thus young healthy people
typically pay in their 14% (half from employer, half from
themselves), yet don't use medical services at all (except,
possibly, for their children). 40 years later, they'll be
using masses of these services, yet be paying in very little
in contributions. It works out, sort of, in the long run.

>> > However, the equilibrator is, once you go private, your
>> > annual premium is determined by the age cohort premium
>> > for the age at which you entered the system. In other
>> > words, as long as there is continuity of coverage
>> > there's no change in premium (other than for
>> > inflation).

>> >> The system has recently been "reformed" (worsened, I
>> >> would say) in that patients now have to pay a 10 Euro
>> >> charge per quarter on visiting a doc., and have to pay
>> >> fairly hefty prescription charges (10% of the cost,
>> >> min. 5 Euros, max 10 Euros, but never more that the
>> >> retail cost itself). Sadly, the government didn't have
>> >> the resolve to tackle the inefficiencies and
>> >> corruption in the various medical and insurance
>> >> systems. Maybe that will come.

>> > In Germany you have one of the more functional and
>> > equitable systems of health care financing. You also
>> > have some of the best quality care and excellent
>> > access. You also have the same set of problems that
>> > other systems face - you are spending a lot of money
>> > for this and the amount you spend keeps going up.

>> Very true.

> And it isn't a single payer system.

Again, what difference would it make if it were? The
Krankenkassen are very tightly regulated on how they take
contributions and what they must pay out. They're much more
like government agencies than insurance companies. What
difference do you think it would make to Germany if there
were only one Krankenkasse?

>> >> I would not swap this system for anything the USA
>> >> currently offers, and would be very wary of moving
>> >> there, even were I completely healthy.

>> > The system you describe IS the system that 163 million
>> > Americans have.

>> Is it not the case that leaving a job in the USA
>> typically imperils one's medical insurance?

> Not necessarily. In fact, it is quite rare though
> politically it is a big to do. There is a system of COBRA
> which provides for health care insurance continuation for
> 18 months. Most people who switch jobs do so in a much
> shorter period. As long as you keep up with the premiums
> you are fully covered. Once you start in your new
> position, you become eligible for the plan there and there
> is a smooth transition.

Hmmm. Only for 18 months? So somebody who loses his job, say
because of injury, is up sheet crick after 18 months? How
much are COBRA contributions, compared with the money the
injured person receives from the public social fund?

>> > Private insurance with premiums funded by
>> > contributions from employees and their employers with
>> > comprehensive cover, nominal cost sharing, and
>> > excellent access and outcomes.

>> The essence of the system in Germany is that it is
>> comprehensive, encompassing everybody. Also that what one
>> pays is dependent only on one's means, not on one's
>> health.

> The positive part of the German system is not the funding
> - however, what is good is that the top end earners pay
> more, but not proportionately more. With a cap of 3500
> Euro or so of income liable to the 7% tax, the costs are
> reasonable. In the absence of the cap, it would be a
> draconian redistribution of wealth.

Draconian? Or Utopian? ;-)

>> The population of the USA is a good deal higher than 163
>> million, isn't it?

> Yes - 40 million are elderly and are covered under
> Medicare. Another 40 million or so have public sector
> insurances - VA, DoD, or Medicaid. And the last 40 million
> have no health care INSURANCE. That makes 283 million
> Americans.

OK, thanks!

> js

--
Alan Mackenzie (Munich, Germany) Email: [email protected]; to
decode, wherever there is a repeated letter (like "aa"),
remove half of them (leaving, say, "a").
 
These discussion say that private enterprise can do it
better. The question is will it do it better. My
experience say this will not happen. It is not government
vs "free enterprise" but is a use of a system that keeps
people in line.

Private people are as abusive and dishonest AS Any
government employee.

Abuse of us by industry is legendary. Today we see the over
reaction to some of this which is also a waste.

A Dr. Caldicott on C-span while touting her book on the
nuclear problems says if we abandoned all of the defense
waste we could have the funds to solve most of our problems
including medical.

All of the money people ignore that money is only a piece
of paper. The real issue is physical resources and
available people.

The real problem is abusive people that want what rightly
belongs to others, I was at the base of the melted tower in
Yucca Flats within two months of a large shot. To me that is
real world. It will be the end product of our greed. The
arguments are over the petty spoils which finally will
disappear in a flash. You may not know it happened. The
neutron burst will boil your brain in microseconds.

After an nuclear exchange radiation problems will be around
for a long time. Allegedly my health problems are from the
exposure to radiation. People in the US have been exposed to
gross fallout and that may be a factor in general health.
The war lords will never admit that.

The C-span item reminded me how trivial the arguments are
here People suffer and die in the US due to lack of medical
care that we are capable of providing. we do not do it for
selfish grabbing for the money. It is that simple.

The same greed will cause the instant vaporization of a lot
of us and all of the toys and assets. The failures of the
human brain will prevent decent medical care and will lead
to Mass destruction.

Rationalize your way out of this possibility. Guy
 
George Conklin wrote:

>> Neither Kerry nor Kucinich have made NHS proposals,
>> though Kerry has promised one as soon as he takes office.
>> His main point, that every American will have the same
>> level of care that members of the US Senate have.
>> Obviously, that is impossible, but he can blame its
>> failure on someone else.
>>
>
> Impossible? You mean that already most of us have
> inferior care? I am surprised you admit it.

Why would I not "admit" it? Haven't I said it a dozen times
in this thread?

Am I not making myself clear, or do you have beans in yer
ears?
 
George Conklin wrote:
> "mike gray" <[email protected]> wrote in message news:uJ1tc.71424$hH.1271479@bgtnsc04-
> news.ops.worldnet.att.net...
>> George Conklin wrote:
>>
>> >> However, Federal accounting and private sector
>> >> accounting are significantly different. But one does
>> >> not have to be a CPA to analyze the data and see that
>> >> gov't programs spend as much on administration as
>> >> private sector companies do.
>> >
>> > Here you go again, claiming falsely that no one
>> > knows how to compute costs but YOU. Shame.
>>
>> I see that English is not yer first language. When I say
>> that "one does not have to be a CPA to analyze the data",
>> that means that anyone with any understanding of charts
>> of accounts can determine for himself what the costs are.
>>
>
>
>
>
>> Even you.
>>
>> And if you bother to do so, you will find that private
>> sector administration costs are not seven times public
>> sector administration costs, as was stated.
>>
>>
>
> Except you are the only one making this false claim.
>
>
Whatever. Believe what ya wanna believe.
 
"Jonathan Smith" <[email protected]> wrote in message
news:[email protected]...
>
> Who ordered the test? Did you get the quote in writing?
> Send them a check for $37 and tell them to sue you for
> the rest.
>
> You have every right to negotiate a price with any
> provider for any service.
>
> js

And he provider has the right to tell you to go elsewhere.
In the current climate they really don't have to negotiate.

--
George Eberhardt
(732)224-8988
 
"Proconsul" <[email protected]> wrote in message
news:j45tc.35443$PU5.19533@fed1read06...
>
> "George Conklin" <[email protected]> wrote in
> message news:[email protected]
> hlink.net...
> || > | >
> | > | > Read past posts again, slowly, for
> | > | > comprehension.....
> | > | >
> | > | > Medicine is more expensive here because it is
> | > | > BETTER
> | > |
> | > | Ah, the big lie. Based on results, it is #38 in
> | > | the world. But
> then
> | > | again I guess you think WHO is just a bunch of
> | > | commies.
> | >
> | > No, but the WHO is run by the UN - a gaggle of third
> | > raters without a
> | moral
> | > center. I wouldn't believe anything they say.
> | >
> | > Just for fun, how do they manage to rate us #38? What
> | > are the
criteria?
> | Who
> | > are the 37 that are better?
> | >
> | > PC
> | >
> |
> | I knew you were going to reject anything but your own
> | opinions, based
> on
> | moral centers, not medical outcomes. Ayn Rand was the
> | most harmful pseudo-intellectual who every lived here.
>
> I "rejected" nothing - I asked you to answer a few fact
> based questions. It's interesting to note that you
> can't/won't and went right back to
bashing
> others.....:)
>
> Quit while you're behind....:)
>
> PC
>
>

Dealing with your pseudo-facts? The WHO clearly stated
their criteria, and it was all posted on tpm at the
time. If you remain ignornant, I suggest you look at
the archives.
 
Jonathan Smith wrote:

> Not true - seniors have access to Medicare Plus Choice (or
> its more recent derivations) PLUS most already subscribe
> to private supplemental, and many have private employer
> retirement health insurance. All the federal employees
> have this as well - top ups and privated, through FEHB.

And in SoFla the most popular participant sport is going to
the doctor's office and *****ing about Medicare.

(snip some good points)

I don't disagree that a privatized system would be ideal.
But I think you grossly underestimate both the problems of
getting national acceptance and of eliminating the gov't
from rules, regulation, and pricing.
 
In article <[email protected]>,
Ted Rosenberg <[email protected]> wrote:

....................

>Two hospitals just flatly lied "we can't quote because we
>don't know how much dye the test will use for each
>individual " (NONE, the test doesn't use dye). The
>remainder quoted prices ranging from $200 to $1,800, of
>course, for insurance companies, it would be about $120
>from all of them !!!

In a libertarian society, the consequences for making false
statements are considerable for the person making them, NOT
the corporation. If higher-ups order it, they are
responsible. No passing the buck to the company.

Also, to prevent some of the abuses you state, it should be
illegal at any time to ask about the kind, if any, of
insurance coverage. Provide the tax advantages now had by
insurance plans by MSAs, and make people responsible. The
one who pays his own bills should not be penalized.

>When the article ran, she got indignant letters from
>hospitals, but fan mail from doctors. They hadn't had a
>CLUE that prices varied from place to place.

>I am also battling a hospital at the moment, I need a
>regular blood test to adjust dosage of some meds. The
>hospital quoted me $37/visit, - fair enough price, even if
>insurance companies would only pay $25. BUT, they BILLED
>amounts ranging from $42.20 to $53.45, when asked why, I
>get a different answer every time I call (on the SAME bill)
>and they are annoyed that I won't pay them until they get
>the bill straightened. And tell me to call the doctor -
>there IS no doctor!. When I ask the pharmacologist at the
>lab, SHE says "that isn't right, you should call billing"

See my earlier statements. We need individual
responsibility, and real competition.
--
This address is for information only. I do not claim that
these views are those of the Statistics Department or of
Purdue University. Herman Rubin, Department of Statistics,
Purdue University [email protected] Phone: (765)494-
6054 FAX: (765)494-0558
 
George Eberhardt wrote:

>> You have every right to negotiate a price with any
>> provider for any service.
>>
>> js
>
> And he provider has the right to tell you to go elsewhere.
> In the current climate they really don't have to
> negotiate.

But they do. All of them. Fact is that a cash pay, even at
the same price charged Medicare, is profitable because
there's no wait for payment and there's very little
billing/collection cost.

Just asking for a deal will get you 15% authorized by a
billing clerk. Bargain hard and you'll get a lot more. It's
just like buying a car.
 
mike gray wrote:
> George Conklin wrote:

>>> And if you bother to do so, you will find that private
>>> sector administration costs are not seven times public
>>> sector administration costs, as was stated.
>>>
>>>
>>
>> Except you are the only one making this false claim.

According to the gov't National Health Accounts, in 2002 the
gov't spent
4.7 % on administration, private health insurers spent 12.8
%

These data are not directly comparable, however, as there
is (1) no gov't charge for administration above the
program level while private sector administration includes
all charges for corporate HQ, board of directors,
security, maintenance, etc. (2) private sector
administration charges include all taxes, from which most
gov't programs are exempt.

Even thus skewed, the gov't/private ratio is 1:2.7, a long
long way from
4:1.

Add to gov't the administrative costs charged to non-health
account programs, and deduct just federal income taxes from
private administration costs and they come out about equal.
 
"Herman Rubin" <[email protected]> wrote in message
news:[email protected]...
> In article <[email protected]>, Ted Rosenberg
> <[email protected]> wrote:
>
> ....................
>
> >Two hospitals just flatly lied "we can't quote because we
> >don't know how much dye the test will use for each
> >individual " (NONE, the test doesn't use dye). The
> >remainder quoted prices ranging from $200 to $1,800, of
> >course, for insurance companies, it would be about $120
> >from all of them
!!!
>
> In a libertarian society, the consequences for making
> false statements are considerable for the person making
> them, NOT the corporation. If higher-ups order it, they
> are responsible. No passing the buck to the company.
>
> Also, to prevent some of the abuses you state, it should
> be illegal at any time to ask about the kind, if any, of
> insurance coverage. Provide the tax advantages now had by
> insurance plans by MSAs, and make people responsible. The
> one who pays his own bills should not be penalized.

When a powerful organization sets up the rules, it takes
a second power organization to bargain for you. In the
medical/industrial world, you have to have an insurance
company bargain for you. You cannot, as an individual,
go up against the established order and not expect to
get screwed.
 
We have seem all kind of response and ideas here. I live
in the real world and no rationalization will change the
fact that a lot of people in the US do not get decent
medical care.

Those in a good position with a plush plan and tenure may
never have faced poor medical care. In fact they usually use
doctors excessively.

All that other trash are useless and do not deserve
anything. "After all we are the cream of out society".

Anyone, anywhere can find an argument the favors their
situation.

Certain parts of the discussion are true but very biased. I
did OK for a lot of years and got very smug. You know things
can change. In my case it did.

I am now more compassionate and have many fewer answers
I doubt if Solomon could solve the mess that we have
let develop.

I was too smug because I was ignorant about a lot of life
and had all of the answers..
 
In article <[email protected]>,
George Conklin <[email protected]> wrote:

>"Ted Rosenberg" <[email protected]> wrote in message
>news:[email protected]...
>> One of the problems of the health care system is that it
>> is not even vaguely a free market. Most health care
>> providers will not provide prices for comparison
>> shopping, and, if they do say anything, it is usually
>> false. They are also not consistent.

> When I have asked about prices, here are the two most
> common answers:

>1. What's the matter? Don't you have insurance?

This is an excellent reason why it is important to get RID
of insurance for all except major or unexpected items, and
to have the prices for ALL up front.

With the pseudo-insurance, you have already paid most, and
it is only the marginal cost which you can now use to decide
whether or not to incur the expense of the procedure. So we
run into the tragedy of the commons.

>2. Ask the nurse. (She does not know or won't say either).

Of course she does not know. She does not handle the money,
nor is she paid for the explicit job.

--
This address is for information only. I do not claim that
these views are those of the Statistics Department or of
Purdue University. Herman Rubin, Department of Statistics,
Purdue University [email protected] Phone: (765)494-
6054 FAX: (765)494-0558