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Frazzled wrote:
bs. I know people who have had MRI's scheduled and done within a week. In fact ALL the MRI's / CT scans were done in a week.

When you have the right insurance plan, sure.

Unfortunately, that's not the case for everyone.

Before I had my current insurance plan, my average wait for an MRI, and I've had many of them, was 4-5 weeks.

Nice try though.

sebster wrote:
You've tried this argument before, that you wouldn't want to have two tiers of healthcare so you couldn't have a public/private hybrid, and it's just ridiculous. The split is not in the quality of actual care, but in the waiting time for non-emergency care, and in how pleasant your stay in hospital is (shared or private room, for instance). Meanwhile you have a system where people who don't have insurance are denied non-emergency care entirely...

Never mind that he's also argued, frequently in the next breath, that medicaid should be done away with entirely.


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Frazzled wrote:
Missed the Medicare part there hoss.

Did medicare suddenly become something other than state funded health insurance?

Frazzled wrote:
Thats what everything is. Your point is nonsensical.

No, my point is that, given the right sort of insurance, minimal wait times for technical care can be assured. But, if you have the wrong sort of insurance, you receive no such guarantee.

I'm differentiating between types of insurance, not insurance and no insurance.

This is a perfectly sensible argument given the context of your quote, as it does not lean on some things being insurance, and other things not being insurance.

Honestly, it isn't that difficult to understand.


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halonachos wrote:With my current insurance I get all the pills and champagne I want. Plus I also get a gold gurney studded with diamonds and IV's filled with liquid caviar.

Now, are you telling me that people without insurance DON'T get that kind of treatment?

No.

Admittedly, I did not explicitly state that I've had insurance since I was born, but that is the stance I'm arguing from. One which indicates that all insurance is not equivalent.

Frazzled wrote:
What insurance is worse than Medicare?

The fact that you think medicare is bad speaks volumes.

Just about any HMO is worse than medicare given a person that travels frequently.

Similarly, low-end PPOs are universally worse than medicare, as they frequently have no drug coverage, and minimal technical levies (ie. they don't pay for MRIs).

Frazzled wrote:
So you don't have any information to support your statement. In that case

What

The

Ever.

Do you want general categorical information, or information about a specific plan?

Honestly, I didn't provide any because you have a history of ignoring any information that is provided. At first glance it appeared to be a waste of my time.

Ok, here's a good example.

To paraphrase, despite acknowledging that MRIs of the breast are useful in detecting breast cancer, CIGNA will not cover breast MRIs because they consider the procedure to be, arbitrarily, experimental. This is generally indicative of managed health care organizations, who often use technical exclusions in order to remove from coverage certain otherwise useful procedures. This is worse than medicare, which has no such restriction policies. Depending on the part restriction, they might pay for a variable amount of the procedure, but they will never pay for none of it.

halonachos wrote:
That's because they 'specialize' in those 'simple' procedures.

Needlessly, in many cases.

Ever had to go to a specialist in order to discover that your GP's diagnosis of a hairline fracture was correct?

I mean really, I could have read the X-Ray with that level of certainty.

halonachos wrote:
Sometimes a doctor isn't sure and they want a second opinion to make sure they don't cause bodily harm, I guess that second opinions are a bad thing?

When they're excessively used, yes.

One of the things we should all learn in life is that certainty doesn't exist outside the incredibly stupid. Its all about making educated guesses according to our best standards of judgment.

Indeed, that's a large part of the argument for tort reform.

halonachos wrote:
As far as treatment goes, we get a lot of bangin' treatment. Does it cost money, hell yeah it does.

The problem is that not everyone can get the treatment right? Oh wait, our system costs a lot too I guess. So if we add more costs then everyone can get champagne and pills right?

No, the problem is that it costs too much compared to other nations that have similar returns.

This is a really basic idea, and it boggles my mind that many people refuse to accept it. I guess its just another pathetic grasp at exceptionalism?

halonachos wrote:
I guess all I can say is that our health system is all sorts of screwed up, but its not the system's fault.

Of course it is, it can't be the fault of anything else as the "system" is a totality.

halonachos wrote:
The government needs to actually pay for services rendered, the government needs to either remove medicare/medicaid and replace it with a new system or fix both,

Medicare and Medicaid have no impact on the overall cost of health care. Because, you know, the government does pay for services rendered.

halonachos wrote:
the government needs to give incentives for people to become doctors,

They already do.

halonachos wrote:
and of course we need to solve our illegal immigrant problem.

A minuscule percentage of the overall health expenditure.

You're literally arguing that a group athat constitutes about 7% of the population makes up about 50% of the excess expenditure. Its a ludicrous argument.

halonachos wrote:
Couple that with changing the american mind set to work less and we could hit the 80 year lifespan Germany is.

How does one change a mindset?

Honestly, your solution is terrible. Absolutely terrible. Maybe if you stopped making excuses you could come up with something better.


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sebster wrote:Stop inventing silly things and just accept that your healthcare system isn't working because of the system.

That can't be the case, America is the best at everything. Everyone else just leaches off our greatness. Especially Australia.

halonachos wrote:
Well that would be true except for the fact that I was using my own personal experience to outline the general outcome for ANY uninsured person. I guess that as soon as someone sees "illegal immigrants" and imply a negative aspect to them others have to put on their blinders and run in saying "Illegal immigrants are people too!". Again, you guys missed the point there.

The problem is that your argument against mandatory insurance turned on the illegal status of the person in question, which is basically the same thing as claiming that illegal immigrants are responsible for excessive health care costs in the US.

Had you not brought up the guy's illegal status, or not used him as an example of why national insurance wouldn't work, there wouldn't have been a problem.

halonachos wrote:
As to our system, hospitals tend to be privately owned with funding for free clinics coming from local or state governments. New York and most major cities have free clinics for the homeless/poor.

Most hospitals also take state funding.

halonachos wrote:
As to our system, it can be fixed and left the way it is as soon as we can find a way to make medical care cheaper. Increasing the amount of doctors and reducing the cost/time it takes to become a doctor is one way to reduce costs. Unless supply and demand don't apply to medical staff for some reason...

The number of doctors isn't the issue. Our physicians per capita statistic is not significantly different from many of the Western nations with superior health care services (right between England and Australia), and is actually significantly worse than the same statistic in a number of nations with inferior health care (Cuba, Argentina, Latvia, Uzbekistan, etc.).

Either way, you're also basically arguing that we should try and fix a complicated issue, health care, by taking another complicated issue, the cost of education. If you're correct, it may be efficient in the sense that two issues would be dealt with simultaneously, but it may not be any easier, and could actually be far more difficult.

halonachos wrote:
If the government decides to entice the hospital with a nifty tax break if it does carry out charitable activities(such as providing preventative medicine to the uninsured) then the hospital would be more willing to do so.

That's basically what happens now, only its not generally tax breaks that are applied, but state subsidization on the condition of admitting emergency patients.

One way or another, people in this country will pay for the health care afforded to others. The question is merely about how open we are about acknowledging that fact.

halonachos wrote:
As to our government paying for services rendered, they do, but it arrives months to years later which is why doctors tend not to accept it. Having insurance is good unless its not accepted anywhere. When we had the government insurance through the military I could only go on base for my prescriptions and only one hospital outside of the bases would accept it. Hell, my optometrist at SEARS didn't even accept it so we had to get another insurance on top of that.

That's not especially different from any basic HMO. Try getting an out of network provider to accept your insurance, or the insurance company to pay, for that matter.

halonachos wrote:Again, the fact that the person was illegal was not the issue. The issue was that the person lacked healthcare and that there was a good amount of fees that were reacked up during the care for the patient. The illegal immigrant status was used to provide background as to why the person lacked insurance in the first place.

Yes, generally, but you also explicitly stated that national, or mandatory, health insurance wouldn't fix the problem because the person in question was illegal. And that, as a result, national health insurance was an insufficient solution. This can only be taken to mean that the number of illegal immigrants in this country is central to the high cost of health care. Maybe that's not the point that you intended to make, but that's certainly what you wrote.

halonachos wrote:
If I said "a person with no insurance" instead of an "illegal immigrant" then I'm sure you would have not responded in the way you did.

Of course not, why would we? Using an illegal immigrant as a specific example explicitly changes the nature of what you're arguing. You could not, for example, say that national health insurance wouldn't be an effective solution, on its face, simply because there are people without insurance; because the explicit point of national health insurance is to reduce the number of people without insurance.

halonachos wrote:
The money earned by insuring x amount of healthy people and y amount of unhealthy people is enough to cover the expenses when one of the y people get ill or in the statistically unlikely event that one of the x people get ill.

Its actually as close to statistically certain as you can get. Anyone who has health insurance will use it. The question isn't regarding usage, its regarding cost when its used. Healthy people are statistically less likely to incur high medical bills, but not necessarily fewer medical bills. In fact, it has been argued that part of being a health person is regular doctor visits for the purposes of preemptive diagnosis; hopefully averting the aforementioned high medical bills.

halonachos wrote:
Would it follow the same basic principle of gambling with illness, yes. But instead of a publicly owned corporation, which follows the typical american tradition of capitalism, it would be a government agency, which follows a non-typical american policy.

Why does the "Americanness" of a thing matter at all? All wondering about that does is gravitate the debate towards "What is America?" That's a cute rhetorical trick, but it isn't particularly conducive to developing physically (as opposed to politically) pragmatic solutions.

halonachos wrote:
A government healthcare would be like giving money to the bank without receiving any interest and best of all the bank gives the money away instead of loaning it.

That's already a significant portion of what insurance companies do. You don't think that covered cancer patients actually pay an amount commensurate with the difference between their health care costs, and those of your average policy holder, do you?

halonachos wrote:
Similar to how we would be paying a tax for a service that we will not receive if we already have insurance and would instead give it to those who are most likely not contributing to that amount of money being used.

Unless of course said service also decreases the overall cost of health care, and thus causes insurance premiums to drop.

halonachos wrote:
As to solving two issues at once being more difficult, yes it would be but taking the easy way out isn't going to help anyone. A half-assed universal healthcare bill will do more damage than good and all possible outcomes need to be considered.

Simply because something is difficult does not indicate that it is the better course of action. Again, that's a cute bit of rhetoric, but it really is meaningless.

halonachos wrote:
We could fix overpriced medicine by capping the prices, but what possible outcomes would we see from that? We could see companies leaving america or we could see them producing less. Or we could see no change except for the price.

And if both of the outcomes were acceptable, then that would be a fine solution.

Either way, I'm not sure what you're trying to illustrate here. Well, other than the basic premise that certain choices involve certain outcomes, which isn't really a point, so much as a matter of self-evidence.

halonachos wrote:
The issue with doctors today is that they will try to avoid the more expensive diagnostic tests if there is a chance they may be considered unnecessary.

From nearly everything I've heard the exact opposite is true, and that the reality is that many doctors over use diagnostic testing. As such, it seems the goal should be to have more doctors be more cautious about the tests they order, which is where tort reform enters the equation.

halonachos wrote:
You can use all of the statistics you want; life span, quality of care, and others all you want, but this issue will most likely only dabble in political science waters. There are too many personal opinions and justifications to allow science to overcome philosophy so in the end it will come to how people feel about it. On that we can agree dogma, everything else not so much.

Actually, my point was that how people feel about the matter is basically irrelevant, and that the state should behave in consistence with a policy of "You're nearly all ignorant plebes." and work to develop the best possible system given the limitations of such an attitude.

halonachos wrote:But the best possible system will not be gained by compromise.

Why not? I mean, the legislative history of the United States doesn't support that idea (Social Security has performed remarkably well for an institution that hasn't been significantly modified in 60 years), and neither does the massive body of literature which states that consensus democracy (Sweden, Canada, Belgium, etc.) produces the best legislative outcomes.

halonachos wrote:
Basic political philosophy follows that very principle and the fact that political philosophy follows to gain what is "just" and "good" means that by its nature it is not objective, but subjective.

What sort of basic political philosophy? I only ask because I've studied political philosophy extensively, and the only real way to make the statement that you just did is to presume that what you learned first, or accept most freely, is the fundamental tenet of an entire body of thought. That's not the case outside the hard sciences which, despite its best attempts to the contrary, political science is not.

Additionally, political philosophy is not necessarily about gaining what is just or good. That's what Platonic political philosophy is about, sure, but we've gotten a lot more sophisticated in the ensuing 2500 years.

halonachos wrote:
When you fall into the world of political science then we see more objective evidence being presented and that's when we see compromises being made and the solution we get is not the best one possible.

The inverse is also true. If what you want is the best possible system, and "best" is defined by a given subjective consideration, then any system that functions in accordance only with one such consideration is going to be something other than the best when considered against all others. This implies that the real question is realizing the best possible solution given all parties involved, even when those parties are mistake as regards what they really want to achieve. Essentially, its the age old question of "What do you really want, X or Y?"

Do you want cheaper health care, or do you want health care based on free market principles? And no, "They're one and the same." is not a valid response, as the question is about personal valuation.

More to the point, there are certain goods that can be considered "objective" in the sense that they only subjective outside the human experience. Health care is an objective good, and you will not find anyone that argues otherwise. Just deserts are not objective goods, because the ideas of who is deserving, and what is just, are not objectively verifiable. As such, the best possible system is the one extends the most care to the most people because objective considerations always outweigh subjective ones in matters where social contracts (read: citizenship), or systemic merit (the worth of a thing across all possible members of a given system) are concerned.

halonachos wrote:
If we want to get the BEST healthcare we will need to argue that it is "just" and sway people based on that concept.

Why? Why not simply argue from what is best? Why change the question into one that is, by your own admission, at least as contentious?

halonachos wrote:
We do have two parties with two different concepts of what is just though. Democrats want hugs for everyone and the republicans want to push old people own the stairs.

Cute rhetoric, no, political philosophy, yes.

No, that's not political philosophy. Its cute rhetoric. The moral arguments put forth by the Republican and Democratic parties are so juvenile and contradictory that calling them philosophy is an injustice; especially seeing their ultimate point is not the creation of a coherent idea of just politics, but swaying voters according to existential biases.

halonachos wrote:
It seems that I did acknowledge the fact that people with conditions do pay more than people who are healthy.

That's not what I asked you. I asked you whether or not the additional amount they pay is commensurate with the additional expenditure incurred in the course of treating them; ie. do they pay for all their additional expenses, or do other people make up the difference in overall cost?

halonachos wrote:
Or it could be taken that under universal healthcare they would not receive healthcare(because they lack citizenship) and that later on we would have to deal with it, most likely because people would argue that they have the right to universal healthcare as well.

That's not a particularly good reason to avoid instituting universal health care, as you're basically contending that a fix for one problem shouldn't be used because it neither fixes, nor worsens, an entirely separate problem.



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halonachos wrote:
As to the undercoding:
http://www.ama-assn.org/amednews/2004/11/22/bil21122.htm
-Undercoding is common to physicians to avoid the hassle of dealing with "the system".

http://www.chiroeco.com/news/chiropractic-news.php?id=2382§ion=63
-Undercoding is a malevolent practice that lowers the value of procedures and does not allow the insurance companies to appreciate the actual value of treatment.

http://www.mgma.com/article.aspx?id=39246

mgma wrote:The audits revealed that, as a group, under-insured patients received the highest percentage of under-coded services. Despite the information – including how undercoding affected their production-based compensation – some providers said they were reluctant to charge under-insured and uninsured patients the full amount knowing that patients would have to cover the fees out-of-pocket.

When they stopped undercoding they had an increase of profit in the amount of $145,000 in office-visit revenue.