Quote:That's the way you have been programmed. Why not? Everyone requires both.
Everyone requires housing and shelter perhaps we should have public housing no one needs a mansion so we should evenly divided lots assign families to them and everyone pays an equal percentage into the housibg system, no more homeless children.
Quote:You are utterly clueless.
At best it would cause inflation due to all the money taken out of taxation. So only the rich would benefit. So that's why you have been programmed to believe this.
I'm clueless?
Sure, there would be a short term inflation because more money in the pockets of consumers was chasing the same amount of consumer goods, but that would settle out quickly.
How do "the rich" benefit from inflation? "The rich" have a much higher percentage of their wealth invested in savings, which becomes less valuable with inflation.
And explain how not having an income tax would affect a person's wages. A corporation does not gain or lose anything because of what the government takes steals from it's workers.
There is no open competition for health care...there are very few independent health care companies out there and about 5 or 6 major companies who own all the rest...The CEO and execs of different companies sit on the boards of the other companies so they are all controlled by the same people...
Quote:Extreme under compensation? How so? Given previous discussion, I wonder if we are talking about the hospitals getting less than those funny money 'list prices' discussed earlier.
Medicaid pays about 28% of what Medicare does, so yeah, severely undercompensated.
Quote:Medicaid pays about 28% of what Medicare does, so yeah, severely undercompensated.
Interesting, I tried to find this, but no luck... source?
Quote:Interesting, I tried to find this, but no luck... source?
<a class="bbc_url" href='https://ahca.myflorida.com/medicaid/review/fee_schedules.shtml'>https://ahca.myflorida.com/medicaid/review/fee_schedules.shtml</a>
Quote:<a class="bbc_url" href='https://ahca.myflorida.com/medicaid/review/fee_schedules.shtml'>https://ahca.myflorida.com/medicaid/review/fee_schedules.shtml</a>
OK, well I saw nothing for a comparison from the link, but I took a few codes and plugged them into a medicare fee lookup I found online. While I had no idea what I was doing, it did look like there was a pretty significant difference between the Medicare reimbursement and the much lower Medicaid info from the link you gave. From what I understand, Florida sets the reimbursement rate for Medicaid. Are they severely underpaying compared to Medicare or am I reading it wrong?
Quote:Extreme under compensation? How so? Given previous discussion, I wonder if we are talking about the hospitals getting less than those funny money 'list prices' discussed earlier.
He is talking about medicaid, and yeah, they reimburse less.
Quote:This seems like the other side of the coin wherein hundreds of thousands go bankrupt due to medical bills. Unfortunately, given the lack of transparency in the system, I have no idea of the true impact of this lack of compensation. If it is partial payment of those $1000 aspirin Samjag talked about earlier (obvious hyperbole from the OP, but you get the drift) I don't have too much concern. But regardless, it is a system where millions do not have access, hundreds of thousands are financially devastated, tens of thousands die due to lack of care, and we spend more than any of the other countries.
I have posted my thoughts on why this situation occurs, but am curious as to yours. How is it that all of the other countries can do so much better and spend so much less? Or do you disagree with the premise that they are doing better and spending less?
I have seen the price list for my hospital(s) on drugs before. I know of none that charge anywhere near $1000 for aspirin. Maybe he meant 1000% cause they charge $10 for a .10 to .25 pill? That would be closer to accurate on the sticker price.
Quote:This seems like the other side of the coin wherein hundreds of thousands go bankrupt due to medical bills. Unfortunately, given the lack of transparency in the system, I have no idea of the true impact of this lack of compensation. If it is partial payment of those $1000 aspirin Samjag talked about earlier (obvious hyperbole from the OP, but you get the drift) I don't have too much concern. But regardless, it is a system where millions do not have access, hundreds of thousands are financially devastated, tens of thousands die due to lack of care, and we spend more than any of the other countries.
I have posted my thoughts on why this situation occurs, but am curious as to yours. How is it that all of the other countries can do so much better and spend so much less? Or do you disagree with the premise that they are doing better and spending less?
Hmm, as far as doing better, that depends on who you are. If your younger and healthier, they are better. If you are older and need a relatively mundane procedure but are above the age cut off, America is great. I had a 70+ year old Canadian come for a procedure a few years ago and was paying cash. I was very curious as to why so I asked her. The Canadian Government had decided she was to old at the low 70's and didn't qualify for it. This despite the fact that she was in great health otherwise, and the procedure was relatively low risk, and would undoubtedly extend her life. So she came down to Florida and had it done for cash.
But then you get on the flipside where you are giving demented 96 year old hip replacements (for the 3 or 4th time) cause they keep jumping out of bed. I guarantee Australia isn't doing that. I have heard it quoted many times that something like 2/3rds of the cost of our care is in the last year of life. You wouldn't get most of that care in other countries.
Does it save them money? Most certainly. Should we do it? Its not an American trait to tell people to just go off to the wood shed and die. Its why there is so much talk about death panels etc. I honestly think our culture is more responsible for the cost than anything else. When people get Cancer in the US, they don't just get their affairs in order, they ask what can I do to beat this? So until just letting folks die becomes culturally acceptable, you won't won't just cut our costs. Medicare tries and just cuts the cost anyway and it doesn't work, cause more people get old and sick than ever before.
So its a double whammy IMO, we have a culture that is both more unhealthy on average, and more unwilling to ride off into the sunset. Combined with our leading role in medical research and development you get the highest cost system in the world. Add in some good ol fashioned greed and middle men, and it becomes even worse. Its just not a black and white thing.
Interestingly people in Australia and Canada live longer.
Quote:Interestingly people in Australia and Canada live longer.
I would argue that has little to do with your actual healthcare, and a lot to do with how you handle junk/processed food. The US has made it extremely cheap to eat bad (we subsidize bad food basically), and as a double whammy allow lots of pesticides that the rest of the developed world doesn't. We spray our food with known tetratogens and probable carcinogens right before harvesting. So we have a less regulated food chain (well its reverse regulated actually, the big companies pick and choose what they want like Monsanto). This is really an aside tho.
I am not arguing that Americans live longer than other nations, they don't. I will argue that it is not due to healthcare that they live less. Other countries, I think, tend to eat better, and exercise more. Its the lifestyle and culture, they eat less red meat, they have better quality food, and make better choices on the whole. Canada's healthcare system rationing care at end of life didn't make their average higher, rather it was everything before that point that improves it.
Aussie's have very similar health concerns. Huge problems with fast food and not enough exercise though admittedly I would trust Aussie cattle to be less pumped with drugs and less pesticides used.
But it has a world class public health system and also private system.
Quote:I would argue that has little to do with your actual healthcare, and a lot to do with how you handle junk/processed food. The US has made it extremely cheap to eat bad
(we subsidize bad food basically), and as a double whammy allow lots of pesticides that the rest of the developed world doesn't. We spray our food with known tetratogens and probable carcinogens right before harvesting. So we have a less regulated food chain (well its reverse regulated actually, the big companies pick and choose what they want like Monsanto). This is really an aside tho.
I am not arguing that Americans live longer than other nations, they don't. I will argue that it is not due to healthcare that they live less. Other countries, I think, tend to eat better, and exercise more. Its the lifestyle and culture, they eat less red meat, they have better quality food, and make better choices on the whole. Canada's healthcare system rationing care at end of life didn't make their average higher, rather it was everything before that point that improves it.
Agree 100% It's cheaper to buy a greasy burger than a healthy salad...Being diabetic I have to eat a pretty rigid diet...The food that is healthy and good for you is so much more expensive than regular food that it's almost being priced out of the market. Here in Pa. the groceries are much more expensive than many other states and then the healthy stuff is incredibly high...I'm not even talking about the organic non gmo stuff either...
Quote:OK, well I saw nothing for a comparison from the link, but I took a few codes and plugged them into a medicare fee lookup I found online. While I had no idea what I was doing, it did look like there was a pretty significant difference between the Medicare reimbursement and the much lower Medicaid info from the link you gave. From what I understand, Florida sets the reimbursement rate for Medicaid. Are they severely underpaying compared to Medicare or am I reading it wrong?
Medicaid is a joint federal and state program. Each state has liberty to set their own fee schedule, but must be within the parameters of the federal guidelines if they want their share of the federal money. That's why Governor Scott's rejection of the new rulesa few years ago was a big deal, Florida didn't change our eligibilty rules and CMS withheld our funds.
Here's their page with tons of information about how that bureaucracy works.
<a class="bbc_url" href='https://www.medicaid.gov/medicaid/financing-and-reimbursement/'>https://www.medicaid.gov/medicaid/financing-and-reimbursement/</a>
Quote:Hmm, as far as doing better, that depends on who you are. If your younger and healthier, they are better. If you are older and need a relatively mundane procedure but are above the age cut off, America is great. I had a 70+ year old Canadian come for a procedure a few years ago and was paying cash. I was very curious as to why so I asked her. The Canadian Government had decided she was to old at the low 70's and didn't qualify for it. This despite the fact that she was in great health otherwise, and the procedure was relatively low risk, and would undoubtedly extend her life. So she came down to Florida and had it done for cash.
But then you get on the flipside where you are giving demented 96 year old hip replacements (for the 3 or 4th time) cause they keep jumping out of bed. I guarantee Australia isn't doing that. I have heard it quoted many times that something like 2/3rds of the cost of our care is in the last year of life. You wouldn't get most of that care in other countries.
Does it save them money? Most certainly. Should we do it? Its not an American trait to tell people to just go off to the wood shed and die. Its why there is so much talk about death panels etc. I honestly think our culture is more responsible for the cost than anything else. When people get Cancer in the US, they don't just get their affairs in order, they ask what can I do to beat this? So until just letting folks die becomes culturally acceptable, you won't won't just cut our costs. Medicare tries and just cuts the cost anyway and it doesn't work, cause more people get old and sick than ever before.
So its a double whammy IMO, we have a culture that is both more unhealthy on average, and more unwilling to ride off into the sunset. Combined with our leading role in medical research and development you get the highest cost system in the world. Add in some good ol fashioned greed and middle men, and it becomes even worse. Its just not a black and white thing.
This is exactly what people dont get, our system spends it's efforts and money in two places, managing old age and combating preventable diseases. Neither of those is something our population can or will change.
Quote:This is exactly what people dont get, our system spends it's efforts and money in two places, managing old age and combating preventable diseases. Neither of those is something our population can or will change.
Totally agree on the managing old age part, which is something I referred to much earlier. What I haven't seen other than one anecdote, is how our system differs regarding the elderly from any other Non-Beveridge system. But this does nothing to explain why our costs for procedures or drugs are so much higher than other countries.
Quote:
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I have heard it quoted many times that something like 2/3rds of the cost of our care is in the last year of life. You wouldn't get most of that care in other countries.
Japan has an older population, and their elderly has more care than in the U.S. Of course their doctors are paid much less than ours. However, I agree with your premise generally, that we spend an inordinate amount of money on the last year or month of life. That was what I was addressing much earlier when I talked about end-of-life care. You are preaching to the choir. :yes:
Its not an American trait to tell people to just go off to the wood shed and die.
Actually, it very much IS an American trait to do just that. That is what we do every year by not having health care systems in place that are similar to the other countries. I posted much earlier about the deaths due to lack of access that other countries simply do not have, yet have heard crickets in response.
So until just letting folks die becomes culturally acceptable, you won't won't just cut our costs.
Your premise is that in the U.S. it is not culturally acceptable for letting (old) folks die, but in other countries it is. So far the only evidence I have seen of this is your one anecdote from Canada. Out of curiosity, what was the procedure? On a more general level, what is the care that would be provided in the U.S. but not say, in any of the other Bismarck countries? I understand that a Beveridge system might ration care in the manner you describe.
Combined with our leading role in medical research and development you get the highest cost system in the world.
No problem with medical R&D, but we are talking about everyday care. I have yet to find a site that compares our costs, procedure by procedure, that does not have us listed in the top 3 for costs, and most often the most expensive. Same for drug costs. My premise stated earlier was pretty simple. We do not have price transparency, and when we do get information into pricing, we are more expensive than other countries. This has nothing to do with the graying of America, or with unneeded hip replacements(though i do not deny the validity of those points). I saw a commentator last week make the observation that folks would consider it crazy to go into a supermarket and pay ten times more for a carrot than the next person in line. Do you believe we can get health care costs in line without price transparency?
I had asked earlier for feedback on how we ranked compared to other countries, and appreciate your views. I also had mentioned goals, such as universal coverage, or getting our health care costs in line with the the next 15 most expensive countries in the world. What would your goals for our system be and how would you get there?
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Could you edit your responses to a more obvious color?
Quote:Medicaid is a joint federal and state program. Each state has liberty to set their own fee schedule, but must be within the parameters of the federal guidelines if they want their share of the federal money. That's why Governor Scott's rejection of the new rulesa few years ago was a big deal, Florida didn't change our eligibilty rules and CMS withheld our funds.
Here's their page with tons of information about how that bureaucracy works.
<a class="bbc_url" href='https://www.medicaid.gov/medicaid/financing-and-reimbursement/'>https://www.medicaid.gov/medicaid/financing-and-reimbursement/</a>
At this point I have no idea why the link you gave me the other day would authorize $100 dollar in Medicaid reimbursement for a procedure that Medicare would pay $400 for, for example. It sounds, however, that it is a state decision to set those rates so low that they would only be 28% of Medicare. Not that that makes the messiness of the program any better, just trying to understand the disparity. From the whole fund matching and oversight standpoint, it seems like a pretty crap system.