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.

 

Drugs: other countries have price caps. That's why there's so much talk about re-importing pharmaceuticals the last 10 years.

 

Procedures: have you compared the cost of overhead expenses including the cost of malpractice insurance?

 

Here's the truth about economics: someone has to pay, always. In this case it's the US who subsidizes all those other healthcare systems in one budget line or another. We pay higher prices because they are price controlled in other places. If we institute similar price controls do you know what we'll get as a result? Hint: healthcare becomes the equivalent of toilet paper in Venezuela. 

---

“An empty vessel makes the loudest sound, so they that have the least wit are the greatest babblers.”. - Plato

Could you edit your responses to a more obvious color?

Done, see above. :thanks:

---

<p class="bbc_left">Education is the cheap defense of nations. - Edmund Burke

<p class="bbc_left"> 

<p class="bbc_left">Or is it from Burke? I tried finding the source, and looked through some of his writings, no luck. Anybody with google-fu got a citation of the source?

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.

 

Because the state government can set it that low, and because state funds available for healthcare are small. Primarily because politicians who raise taxes don't get reelected. And, as with any government program, what starts out as a good idea evolves into unmanageable bureaucracy.

---

“An empty vessel makes the loudest sound, so they that have the least wit are the greatest babblers.”. - Plato

Drugs: other countries have price caps. That's why there's so much talk about re-importing pharmaceuticals the last 10 years.

Exactly why I believe we should also negotiate pricing similar to all those other countries. I would add that the lack of patent expiration for biologics poses a huge issue down the road. 


 

Procedures: have you compared the cost of overhead expenses including the cost of malpractice insurance?

Sigh, I guess I will have to reply to Rob's post on malpractice. I was holding off because I didn't want to sound too harsh. But yes, I have looked, and from what I have seen the malpractice costs are no a main driver. Maybe I will start a different thread on malpractice and health care, as I don't want to derail too much.

 

Here's the truth about economics: someone has to pay, always. In this case it's the US who subsidizes all those other healthcare systems in one budget line or another. We pay higher prices because they are price controlled in other places. If we institute similar price controls do you know what we'll get as a result? Hint: healthcare becomes the equivalent of toilet paper in Venezuela. 

No offense, but that sounds absurd. It has nothing to do with procedure costs, and If we did place such controls, that the costs would be averaged over the other countries, or the companies would go from making record profits to decent profits, or they would go [BLEEP] up and their researchers would go to other companies. 

---

<p class="bbc_left">Education is the cheap defense of nations. - Edmund Burke

<p class="bbc_left"> 

<p class="bbc_left">Or is it from Burke? I tried finding the source, and looked through some of his writings, no luck. Anybody with google-fu got a citation of the source?

Because the state government can set it that low, and because state funds available for healthcare are small. Primarily because politicians who raise taxes don't get reelected. And, as with any government program, what starts out as a good idea evolves into unmanageable bureaucracy.

OK, that sounds about right to me. Medicaid in its current form seems like a dog.

---

<p class="bbc_left">Education is the cheap defense of nations. - Edmund Burke

<p class="bbc_left"> 

<p class="bbc_left">Or is it from Burke? I tried finding the source, and looked through some of his writings, no luck. Anybody with google-fu got a citation of the source?

Oh dear...

 

http://edition.cnn.com/2017/02/27/politi...mplicated/

---

<blockquote class="ipsBlockquote" data-author="flsprtsgod" data-cid="969894" data-time="1488128708">
Drugs: other countries have price caps. That's why there's so much talk about re-importing pharmaceuticals the last 10 years.
Exactly why I believe we should also negotiate pricing similar to all those other countries. I would add that the lack of patent expiration for biologics poses a huge issue down the road. 


 

Procedures: have you compared the cost of overhead expenses including the cost of malpractice insurance?

Sigh, I guess I will have to reply to Rob's post on malpractice. I was holding off because I didn't want to sound too harsh. But yes, I have looked, and from what I have seen the malpractice costs are no a main driver. Maybe I will start a different thread on malpractice and health care, as I don't want to derail too much.

 

Here's the truth about economics: someone has to pay, always. In this case it's the US who subsidizes all those other healthcare systems in one budget line or another. We pay higher prices because they are price controlled in other places. If we institute similar price controls do you know what we'll get as a result? Hint: healthcare becomes the equivalent of toilet paper in Venezuela. 
No offense, but that sounds absurd. It has nothing to do with procedure costs, and If we did place such controls, that the costs would be averaged over the other countries, or the companies would go from making record profits to decent profits, or they would go [BAD WORD REMOVED] up and their researchers would go to other companies. 

</blockquote>


Section 1, Who are you negotiating on behalf of and by what authority?


Section 2, malpractice contributes to the RVU for reimbursement, thats a cost not reported by examining premiums.


Section 3, scarcity is the basic premise of economics. Price controls increase it. Always.

---

“An empty vessel makes the loudest sound, so they that have the least wit are the greatest babblers.”. - Plato

Drugs: other countries have price caps. That's why there's so much talk about re-importing pharmaceuticals the last 10 years.


Procedures: have you compared the cost of overhead expenses including the cost of malpractice insurance?


Here's the truth about economics: someone has to pay, always. In this case it's the US who subsidizes all those other healthcare systems in one budget line or another. We pay higher prices because they are price controlled in other places. If we institute similar price controls do you know what we'll get as a result? Hint: healthcare becomes the equivalent of toilet paper in Venezuela.

Scarcity will out

---

Section 1, Who are you negotiating on behalf of and by what authority?


Section 2, malpractice contributes to the RVU for reimbursement, thats a cost not reported by examining premiums.

Section 3, scarcity is the basic premise of economics. Price controls increase it. Always.

 

The only way that you can decrease the price of a good or service and increase its production is to reduce the amount of capital needed to deliver that good or service.  More regulations and controls aren't going to achieve that.  Creating more massive bureaucracies can't achieve that because somewhere down the line, we have to pay for the bureaucracies through taxes and fees. 

 

Artificially low prices manifest themselves in the form of less services being provided and rationing.  That's why the 70 year old has to come to America to get certain care.

---

Section 1, Who are you negotiating on behalf of and by what authority?

Basically advocating using the same principal as all of the other industrialized democracies that are doing a better job with health care. I am not as concerned with whether we go with a NHI or Bismarck model. I doubt a Beveridge model would get as much traction here, as it involves too much government control. I would imagine Bismarck is the most likely model that would work. But in all of them, whether the insurance companies, doctors or hos[itals are private or public, non-profit or for-profit, the government sets the rates. 


 

Section 2, malpractice contributes to the RVU for reimbursement, thats a cost not reported by examining premiums.

Malpractice is definitely an issue. I wish I could remember the specific example in one of the books I had read on the subject, but at least one of the countries has a pretty nice system that insures medical practitioners against exposure if they were following generally accepted practices and not being grossly negligent. A good example might be a guideline involving shoulder dystocia mitigating the over-performance of C-sections. 



Section 3, scarcity is the basic premise of economics. Price controls increase it. Always.

Every other industrialized democracy disagrees. You made a totally unsubstantiated claim regarding us subsidizing the plans of every other country. On it's face it seems ludicrous, as I stated above. As I also explained, it has no bearing on medical procedures. How does the price of a shoulder replacement procedure in Paris create greater expense in Jacksonville? And sorry, but one anecdote of a Canadian visiting is weak sauce. 


 

---

<p class="bbc_left">Education is the cheap defense of nations. - Edmund Burke

<p class="bbc_left"> 

<p class="bbc_left">Or is it from Burke? I tried finding the source, and looked through some of his writings, no luck. Anybody with google-fu got a citation of the source?

The only way that you can decrease the price of a good or service and increase its production is to reduce the amount of capital needed to deliver that good or service.  More regulations and controls aren't going to achieve that.  Creating more massive bureaucracies can't achieve that because somewhere down the line, we have to pay for the bureaucracies through taxes and fees. 

 

Artificially low prices manifest themselves in the form of less services being provided and rationing.  That's why the 70 year old has to come to America to get certain care.

Again, empirically disproved via all of the other countries. Switzerland is actually an example of a country that had a system similar to ours, and has switched to a Bismarck system (back in 1994). 

---

<p class="bbc_left">Education is the cheap defense of nations. - Edmund Burke

<p class="bbc_left"> 

<p class="bbc_left">Or is it from Burke? I tried finding the source, and looked through some of his writings, no luck. Anybody with google-fu got a citation of the source?

Lets rewind. No CNN, Fox News,or any other so called "Fake News". Just Trump's own words on healthcare. Dare I save his promises?


-Everybody will get insurance

-Will not cut Medicaid

-Pre Existing conditions will stay

-Lower deductibles


All these were promised yet the lawmakers are doing the opposite. Did his voters sign up for this?

---

<a class="bbc_url" href='https://www.google.com/amp/s/www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/amp/'>https://www.google.com/amp/s/www.forbes.com/sites/theapothecary/2011/04/29/why-switzerland-has-the-worlds-best-health-care-system/amp/</a>


Again, empirically disproved via all of the other countries. Switzerland is actually an example of a country that had a system similar to ours, and has switched to a Bismarck system (back in 1994).

99.5% of Swiss citizens have health insurance. Because they can choose between plans from nearly 100 different private insurance companies, insurers must compete on price and service, helping to curb health care inflation. Most beneficiaries have complete freedom to choose their doctor, and appointment waiting times are almost as low as those in the U.S., the world leader.

---

So much for repealing and replacing on day one.  Or was it the first week?   End of the year?   Next year?    It keeps changing. 

 

http://www.msn.com/en-us/news/politics/trump-concedes-health-law-overhaul-is-%e2%80%98unbelievably-complex%e2%80%99/ar-AAnBZmM?li=BBnbcA1

 

WASHINGTON — President Trump, meeting with the nation’s governors, conceded Monday that he had not been aware of the complexities of health care policy-making: “I have to tell you, it’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”

 

Well, duh.  

---

Again, empirically disproved via all of the other countries. Switzerland is actually an example of a country that had a system similar to ours, and has switched to a Bismarck system (back in 1994). 

 

You really think the US and the Swiss are a reasonable comparison when you factor in population, climate, culture and geography?

---

“An empty vessel makes the loudest sound, so they that have the least wit are the greatest babblers.”. - Plato

 

<blockquote class="ipsBlockquote" data-author="flsprtsgod" data-cid="970660" data-time="1488253706">
<div>
Section 3, scarcity is the basic premise of economics. Price controls increase it. Always.

Every other industrialized democracy disagrees. You made a totally unsubstantiated claim regarding us subsidizing the plans of every other country. On it's face it seems ludicrous, as I stated above. As I also explained, it has no bearing on medical procedures. How does the price of a shoulder replacement procedure in Paris create greater expense in Jacksonville? And sorry, but one anecdote of a Canadian visiting is weak sauce. 


 

 

</div>
</blockquote>
 

Hardly 1 Canadian and hardly an anecdote:http://http://news.nationalpost.com/news/canada/number-of-canadian-patients-travelling-abroad-for-treatment-increased-by-25-study-finds

---

“An empty vessel makes the loudest sound, so they that have the least wit are the greatest babblers.”. - Plato

Lets rewind. No CNN, Fox News,or any other so called "Fake News". Just Trump's own words on healthcare. Dare I save his promises?


-Everybody will get insurance

-Will not cut Medicaid

-Pre Existing conditions will stay

-Lower deductibles


All these were promised yet the lawmakers are doing the opposite. Did his voters sign up for this?

 

That's before he realized how complicated it is. Don't you know Paul Ryan cries himself to sleep every night, murmuring "this is who I have to work with to get a new health care bill?"

 

I expect very vague generalities in the speech tonight. Donald is not exactly a policy wonk. Then I expect him to start backing away from what he said on the campaign trail. 

---

The sun's not yellow, it's chicken.

That's before he realized how complicated it is. Don't you know Paul Ryan cries himself to sleep every night, murmuring "this is who I have to work with to get a new health care bill?"


I expect very vague generalities in the speech tonight. Donald is not exactly a policy wonk. Then I expect him to start backing away from what he said on the campaign trail.

I heard something about giving credits to individuals to purchase a plan based on age instead of income. Seems really dumb that a 70 year old millionaire could qualify for the same credit as a 70 year old man who collects maybe 20k or less in social security. What is wrong with this country?

<a class="bbc_url" href='http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits'>http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits</a>

---

That's before he realized how complicated it is. Don't you know Paul Ryan cries himself to sleep every night, murmuring "this is who I have to work with to get a new health care bill?"


I expect very vague generalities in the speech tonight. Donald is not exactly a policy wonk. Then I expect him to start backing away from what he said on the campaign trail.

Hater!!!

---

I heard something about giving credits to individuals to purchase a plan based on age instead of income. Seems really dumb that a 70 year old millionaire could qualify for the same credit as a 70 year old man who collects maybe 20k or less in social security. What is wrong with this country?

<a class="bbc_url" href='http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits'>http://www.npr.org/sections/health-shots/2017/02/24/517074764/gop-health-bill-draft-would-cut-medicaid-emphasize-tax-credits</a>

So dissapointing!!!!

---