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It's not medical rationing

Home Forums General Columbus Discussion Everyday Chit Chat It’s not medical rationing

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  • #410782
    rus
    rus
    Participant

    joev wrote >>

    Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Why do you have such faith that one set of bureaucrats is better than another?

    #410783

    joev
    Participant

    rus wrote >>

    joev wrote >>
    Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Why do you have such faith that one set of bureaucrats is better than another?

    Because I can vote one set of bureaucrats out of office, and their #1 goal is to do the right thing for the voters. The other set of bureaucrats have profit as their #1 goal, and voters don’t have a national performance review of their work every four years.

    #410784

    Andrew Hall
    Member

    joev wrote Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Accountability is a dual-edged sword. One might call it ‘giving into to political pressure’ instead of evidence. Mammograms, for example.

    Maybe we do make a collective decision that saving a life is worth more than the cost of doing so. And that saving a life from X disease is more important than saving one from Y disease – which is exactly the “accountability” that government is going to have.

    A.

    #410785
    rus
    rus
    Participant

    joev wrote >>

    rus wrote >>

    joev wrote >>
    Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Why do you have such faith that one set of bureaucrats is better than another?

    Because I can vote one set of bureaucrats out of office, and their #1 goal is to do the right thing for the voters. The other set of bureaucrats have profit as their #1 goal, and voters don’t have a national performance review of their work every four years.

    Alternatively, outside of government interference one should be able to choose between insurance providers ( even across state lines ) at whim. Vote with one’s feet, as it were.

    Also, “do the right thing for voters” just makes me laugh. Figure you and I have different perspectives on that.

    I agree with Andrew that cost issues are being overlooked.

    #410786

    Tenzo
    Participant

    Brent wrote >>
    provide evidence why your particular treatment recommendations work and/or are better instead of hiding behind the veil that the doctor knows best because that’s how he/she has 20-40 years of experiance .

    Fixed that for you.

    So professional expieriance is bad?

    #410787

    Andrew Hall
    Member

    Tenzo wrote >>

    Brent wrote >>
    provide evidence why your particular treatment recommendations work and/or are better instead of hiding behind the veil that the doctor knows best because that’s how he/she has 20-40 years of experiance .

    Fixed that for you.
    So professional expieriance is bad?

    All too often. We daily see docs who keep doing what they’ve been doing for years with no regard for new information.

    A.

    #410788

    berdawn
    Member

    Andrew Hall wrote >>

    joev wrote Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Accountability is a dual-edged sword. One might call it ‘giving into to political pressure’ instead of evidence. Mammograms, for example.
    Maybe we do make a collective decision that saving a life is worth more than the cost of doing so. And that saving a life from X disease is more important than saving one from Y disease – which is exactly the “accountability” that government is going to have.
    A.

    We could first make a collective decision that advanced directives are well-worth doing before then.

    unrelatedly, the fact that republicans are bitching about what is essentially the same plan they *wanted* 20 years ago amazes me.

    #410789

    Tenzo
    Participant

    Cookie wrote >>

    rus wrote >>
    “Obmamacare” sounds as much like a slogan or buzzword as “Romneycare”. Both can be used by their opponents, sure, but they also serve to quickly identify the laws and regulations in question, yes?

    Yes, like death panels.

    Your argument would make sense if a “Mr. Death” were heading the panel.

    It’s the difference between calling that response a ‘cookie-ism’ or a ‘wack-job-rant’.

    But maybe it’s just me. I’ve never been good at being ‘politicaly correct’ for the sake of it. Let me see if I have the drift.

    Obamacare = Bad Phrase
    Bush Tax cuts = Good Phrase

    ???

    #410790

    gramarye
    Participant

    joev wrote >>

    gramarye wrote >>

    joev wrote >>

    Brent wrote >> Physicians like to cry about lots of things relating to government just like every other citizen. 46% aren’t going to quit just because the changes in the healthcare bill went into effect. They may not like being “told what to do by a government bureaucrat”, but they’re already being told what to do by an insurance company bureaucrat.

    + 1 billion. I would much rather have the government making these calls – the government is accountable to us. Insurance companies are only accountable to their shareholders. Large numbers of doctors aren’t going to leave the industry – just the few, vocal crybabies.

    The notion that the government is accountable to us is laced with a particularly bitter irony in this case, given the way Obamacare was maneuvered through the Senate, particularly after the election of Scott Brown, who made the explicit campaign pledge–successfully, even in Massachusetts–of being the critical vote against it.

    Well, let me ask it this way: Which is more accountable to the general public who use healthcare services, insurance companies or the government?

    Insurance companies.

    Insurance companies are accountable to the general public because public has the ability (though not the unlimited ability, thanks to government interference in what would otherwise be citizens’ perfectly natural right to buy insurance from another state) to walk. That directly hurts an insurance company’s bottom line. Likewise, doctors are free to decline given insurance programs, and in fact, many do (basically no doctor accepts everything), if they think the proposed terms are not worth it. This system of accountability is imperfect, and everyone has something to complain about regarding insurance companies, but there is a reason that most people who have private coverage are happy with it. For most people and most conditions, insurance companies *are* in fact responsive. I’m happy with mine.

    The government can be nonresponsive on this front and hope to make it up on other fronts, because it represents a much more dilute form of accountability. For example, I might utterly despise a given government’s handling of health care but feel obliged to vote for them because of other positions on which I disagree with the other side even more vehemently. In addition, as others have already noted, governments are susceptible to internal political pressures that have essentially nothing to do with health care outcomes. This all happens without even dealing with the power of the government to bring redistributionist ideology into the picture, which of course no insurance company could do even if it wanted.

    And, of course, there is nothing wrong with paying for health services oneself. I paid in cash for my laser eye surgery, using my HSA (which effectively got me a discount because I got to pay with untaxed income).

    #410791

    Tenzo
    Participant

    Andrew Hall wrote >>

    Tenzo wrote >>

    Brent wrote >>
    provide evidence why your particular treatment recommendations work and/or are better instead of hiding behind the veil that the doctor knows best because that’s how he/she has 20-40 years of experience .

    Fixed that for you.
    So professional experience is bad?

    All too often. We daily see docs who keep doing what they’ve been doing for years with no regard for new information.
    A.

    Really?
    If you have seen this then just choose a new doctor.

    When I choose a doctor I ask their age, sex, where they went to medical school, are they active in teaching, what certs they hold and are they active in research.

    If you are just playing Russian roulette with choosing people then put the responsibility right where it belongs. On yourself. How would you hire someone for a job? The first one who answers the ad?
    If you hired someone to work on your house would you take the first one who showed up?
    No? Then why the heck would you do that with your own life?
    Why the heck would you want to relegate that kind of personal responsibility to someone else?

    #410792

    Andrew Hall
    Member

    Tenzo wrote >>

    Andrew Hall wrote >>

    Tenzo wrote >>

    Brent wrote >>
    provide evidence why your particular treatment recommendations work and/or are better instead of hiding behind the veil that the doctor knows best because that’s how he/she has 20-40 years of experience .

    Fixed that for you.
    So professional experience is bad?

    All too often. We daily see docs who keep doing what they’ve been doing for years with no regard for new information.
    A.

    Really?
    If you have seen this then just choose a new doctor.
    When I choose a doctor I ask their age, sex, where they went to medical school, are they active in teaching, what certs they hold and are they active in research.
    If you are just playing Russian roulette with choosing people then put the responsibility right where it belongs. On yourself. How would you hire someone for a job? The first one who answers the ad?
    If you hired someone to work on your house would you take the first one who showed up?
    No? Then why the heck would you do that with your own life?
    Why the heck would you want to relegate that kind of personal responsibility to someone else?

    I love how your arrogance assumes so much and wants to talk down to me!

    I run a specialist office. I see the results of docs who have “experience” which equates to doing the same things for years regardless of current knowledge.

    A.

    #410793

    dru
    Participant

    gramarye wrote
    And, of course, there is nothing wrong with paying for health services oneself. I paid in cash for my laser eye surgery, using my HSA (which effectively got me a discount because I got to pay with untaxed income).

    which would largely solve any real issue of rationing or patient/doctor interference.

    but I imagine 99% of the 46% of the doctors who threatened to quit in the survey (i don’t recall a citation for the survey) do not mind getting paid via the government for their patients that are on government funded programs. they just want to dictate with little accountability to spiraling cost. we can remove these programs and their payments, and I presume see a huge part of their practice disappear (especially for specialist practices) when average people cannot afford them (unless fees drop considerably in an unsubsidized market). without subsidies, some % of that group might find themselves jobless or underemployed involuntarily.

    in practice, an equally big percentage of the US populace that rely on these programs also don’t mind having part or all of their health care covered. if people like @Tenzo want the best care available from a doctor with 30-40 years experience, fine, step up and pay for it out-of-pocket.

    there has been nothing I’ve seen (though I surely could have missed something) in the health care legislation that would prevent a patient from getting exactly the coverage/procedures they wanted in consultation with their doctor if they wanted/could pay for it without government assistance.

    #410794

    Andrew Hall
    Member

    gramarye wrote
    Insurance companies are accountable to the general public because public has the ability (though not the unlimited ability, thanks to government interference in what would otherwise be citizens’ perfectly natural right to buy insurance from another state) to walk. That directly hurts an insurance company’s bottom line. Likewise, doctors are free to decline given insurance programs, and in fact, many do (basically no doctor accepts everything), if they think the proposed terms are not worth it. This system of accountability is imperfect, and everyone has something to complain about regarding insurance companies, but there is a reason that most people who have private coverage are happy with it. For most people and most conditions, insurance companies *are* in fact responsive. I’m happy with mine.

    I partly agree, but there are deep problems. The main one is that insurance companies do not respond to market pressure from the consumer or, more accurately, the individual is NOT the consumer – the benefits manager of the employer is. The insurance company sells product to them and, in this current climate of higher unemployment, they don’t have a large incentive to do better by their employees and lots of incentive to go cheap.

    Secondly and probably the larger problem in the long run is that a private insurance company has a huge incentive to NOT cover chronic conditions whose large medical costs won’t be born until after years of non-treatment. This is because current costs can be high and the patient will likely be Medicare’s problem when the larger costs hit.

    There are many obstacles to private insurance running truly in a market-responsive fashion and not all of them are regulatory.

    A.

    #410795

    columbusfoodie
    Participant

    Mercurius wrote >>

    gramarye wrote >>

    rus wrote >>

    Cookie wrote >>

    rus wrote >>
    “Obmamacare” sounds as much like a slogan or buzzword as “Romneycare”. Both can be used by their opponents, sure, but they also serve to quickly identify the laws and regulations in question, yes?

    Yes, like death panels.

    Explain to me how a deliberate distortion is the same as shorthand identification.

    +1
    If Obamacare were more popular, the president would be encouraging his supporters to use that shorthand at every opportunity.
    You can’t say the same thing about “death panels,” a deliberate pejorative.

    People don’t like uncertainty. All other countries where law requires healthcare, that healthcare is extremely popular. Probably the same will be true of the Patient Protection and Affordable Care Act, once it goes into effect. Until it goes into effect, there is too much uncertainty. For example, does Columbus Foodie know that because of this law, insurers are prohibited from discriminating against or charging higher rates for any individuals based on pre-existing medical conditions – but not ’til 2014. I’d bet come 2014, she likes that?
    There is certainly room to complain – mainly if you are a small business owner who currently does not offer health care, if you make over $200,000 or if you are an individual that is relatively healthy and currently don’t have health care.
    Read the actual bill, and ignore the hyperbole above.

    Re: the discrimination and charging higher rates to an individual, that’s only applicable in an individual health plan, of which I’m practically uninsurable individually because I’ve had a gastric bypass (go figure – I’m way healthier than I was at 500 lbs, but that thing alone disqualifies me from being underwritten). Under a group plan, you’re paying the same rate for insurance as the guy in the next cubicle.

    Re: pre-existing conditions, what most people don’t understand is that as long as there is no more than a 60 day gap between insurance policies, you have creditable coverage that waives any pre-existing clause in the contract. However, since this is not common knowledge, and because there are not enough people who understand the system advocating for people who don’t, many people just accept that something isn’t covered because of a pre-existing condition while in reality (and under the terms of the contract) it should be. I’ve had no gaps, so I’m not too worried about pre-existing issues.

    I don’t like ObamaCare, even though I agree with a few parts of it (including that section about pre-existing conditions you are talking about). Depending on what way you look at it, I think it’s either too far reaching and invasive, or not aggressive enough. Meaning, if you’re going to spend billions of dollars on implementing universal health care, either go full hog and cover everyone completely from cradle to grave (and add the infrastructure required to support that), or just fix the parts that are broken. Now is the time where everyone is signing up for their benefits for 2011, I’d be interested to know if we’re the only ones who saw a much more inferior plan that costs a lot more than it has in previous years?

    #410796

    gramarye
    Participant

    dru wrote >>

    gramarye wrote
    And, of course, there is nothing wrong with paying for health services oneself. I paid in cash for my laser eye surgery, using my HSA (which effectively got me a discount because I got to pay with untaxed income).

    which would largely solve any real issue of rationing or patient/doctor interference.
    but I imagine 99% of the 46% of the doctors who threatened to quit in the survey (i don’t recall a citation for the survey) do not mind getting paid via the government for their patients that are on government funded programs. they just want to dictate with little accountability to spiraling cost. we can remove these programs and their payments, and I presume see a huge part of their practice disappear (especially for specialist practices) when average people cannot afford them (unless fees drop considerably in an unsubsidized market). without subsidies, some % of that group might find themselves jobless or underemployed involuntarily.

    They might. Or they might have to adapt. Either way, I would be comfortable with that result.

    there has been nothing I’ve seen (though I surely could have missed something) in the health care legislation that would prevent a patient from getting exactly the coverage/procedures they wanted in consultation with their doctor if they wanted/could pay for it without government assistance.

    Even if this is technically true, the reengineering of the health care sector in response to this legislation will in practice affect the market options available to cash patients, too. In economics, we call it the “crowding out” effect. Providers, knowing which side their bread is buttered on, will orient themselves towards the entitlement program. Cash patients, to the extent their interests are any different, will become an afterthought.

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