Whatcha think Pawdawg: ACA replacement

[RhythmDawg]

Nah, not wrong. Everyone has experienced ridiculous charges across all aspects of healthcare. From their family doctors to specialists to hospitals, and services. Those charges are artificially inflated. Part of the reason charges are out of control is the stupid-azz guvmint setting prices via Medicare/Medicaid. "We will pay $XXXX for said procedure." So, so much for the market setting the real price for that procedure.

Before this goes much further, I want to state I have nothing but the utmost respect and admiration for healthcare providers, the nurses and doctors and the other skilled personnel who deliver the actual services. This is not about them, or what they do. This is about the out-of-control "costing" practices that has driven costs so high we find ourselves, well, where we are.

Next, back to the stupid-azz guvmint and the ridiculous regulations and restrictions that drive up costs, with no appreciable benefit. Pharma faces asinine regulations on testing new drugs/products that eventually leads to high costs of those medicines. Pharma has to spend $millions "proving" their new drugs are safe and/or do what they say they do. Is that a bad thing? No, not on the surface. Of course drugs should be safe and actually work. But, at some point, that case has been made, yet FDA requires years of additional testing, etc... Then, for we Americans, we have to pay more for drugs because other countries are willing to accept new drugs without all the additional testing, and in many cases, foreign guvmints subsidize drugs for their citizens. So....we alone have to pay for all the overhead connected to new drugs being developed.

Guvmint interference in healthcare, in general, is the main reason costs have gotten out-of-hand. And that includes allowing the practice of write-offs against taxes.

You got a few things right in that one. I'll expound on the subject when I get some time this weekend. It will require a long post.

[Soonerdawg]

Yes, thankfully! I am not a scumbag!

Apparently you are.

[dawg80]

Oh really? Because I don't want lawyers causing healthcare costs to be high I'm a "scumbag?" Yeah, right.

Well, you know what Shakespeare said about lawyers....

[Soonerdawg]

Oh really? Because I don't want lawyers causing healthcare costs to be high I'm a "scumbag?" Yeah, right.

Well, you know what Shakespeare said about lawyers....

Your ignorance of the law is apparently exceeded by your ignorance of Shakespeare.

[dawg80]

Okay, Dick the Butcher.

Doesn't change the fact that lawyers are lowlifes that prey on those who actually produce in our society. You like to condemn the guvmint, and bureaucraps, and I suppose that's because you want you lawyers free of the competition to bilk people.

Back to the topic...

In medical malpractice cases there should be NO lawyers allowed. Instead a judge, on a fixed salary, hears the case directly from the principals. They can bring in expert witnesses, such as other doctors. And, it is all codified. The judge has no discretion to award any extra damages. If liability is found, the amount is calculated using a set formula.

In this way insurance companies will know what the risk is, what the damages will be, and can price malpractice insurance accordingly.

[RhythmDawg]

Okay, Dick the Butcher.

Doesn't change the fact that lawyers are lowlifes that prey on those who actually produce in our society. You like to condemn the guvmint, and bureaucraps, and I suppose that's because you want you lawyers free of the competition to bilk people.

Back to the topic...

In medical malpractice cases there should be NO lawyers allowed. Instead a judge, on a fixed salary, hears the case directly from the principals. They can bring in expert witnesses, such as other doctors. And, it is all codified. The judge has no discretion to award any extra damages. If liability is found, the amount is calculated using a set formula.

In this way insurance companies will know what the risk is, what the damages will be, and can price malpractice insurance accordingly.

Do you know how much malpractice insurance costs? It isn't that expensive. I am unaware of any hospital or physician, in any specialty, struggling anywhere in the country because of malpractice premiums.

I assure you, with every fiber of my being, that malpractice cases are not driving up the costs of healthcare services, despite what you may hear in the media from politicians. I know zero -none- hospitals of any size even thinking about malpractice cases when they set their fee schedules...particularly the ones for which I personally set their fee schedules.

[Soonerdawg]

Okay, Dick the Butcher.

Doesn't change the fact that lawyers are lowlifes that prey on those who actually produce in our society. You like to condemn the guvmint, and bureaucraps, and I suppose that's because you want you lawyers free of the competition to bilk people.

Back to the topic...

In medical malpractice cases there should be NO lawyers allowed. Instead a judge, on a fixed salary, hears the case directly from the principals. They can bring in expert witnesses, such as other doctors. And, it is all codified. The judge has no discretion to award any extra damages. If liability is found, the amount is calculated using a set formula.

In this way insurance companies will know what the risk is, what the damages will be, and can price malpractice insurance accordingly.

It would follow that one who knows so vey little about the law would also know very little about the important role lawyers play in a free society.

Also, what you and the butcher do together really should be kept between you and the butcher.

[Guisslapp]

As a person with a libertarian bent, I am ready to concede that we should just move to a universal single-payer system (with a cash/3rd party system overlaying it for those that want more than the base universal system provides).

I am for small government and freedom, but there are two realities that I feel like we must accept at this point.

1. Our country will not allow people that need health care not get it. I don't believe in a right to health care, but apparently Americans as a whole are not willing to allow preventable unfortunate outcomes happen to people. Even those that don't believe in the right to health care let their morality override their politics. EMTALA (which will never be repealed) provides a mechanism assuring that anyone will always get the most expensive form of care if they don't take other responsible measures to take care of themselves. This just results in economic inefficiencies that those of us that don't believe in a right to health care must continue to bear SOLELY because we are unwilling to let go of our small government ideals.

2. Third party payment systems themselves are too complex for Americans. Let's face it. Most of us posting on this thread lack the ability to read and understand the policies we are signing up for. And if we can understand it, we might be poorly equipped to really evaluate the nature of the risks that we should be taking. If you are shopping two policies or more (which we need to be doing to keep costs reasonable), then understanding the differences and the relative importance of the differences is also hard to sort out. If this is something that is relatively hard and time consuming - imagine what it must be like for people that didn't go to LaTech or have less life experience to understand what they really need.

What we have now is an entitlement in practice that because we don't want to call it what it is, we are bearing much more cost and profiting people that really have less to do with the delivery of the health care.

[dawg80]

I'm not willing to concede at this point. We still have our "trump" card.

[RhythmDawg]

As a person with a libertarian bent, I am ready to concede that we should just move to a universal single-payer system (with a cash/3rd party system overlaying it for those that want more than the base universal system provides).

I am for small government and freedom, but there are two realities that I feel like we must accept at this point.

1. Our country will not allow people that need health care not get it. I don't believe in a right to health care, but apparently Americans as a whole are not willing to allow preventable unfortunate outcomes happen to people. Even those that don't believe in the right to health care let their morality override their politics. EMTALA (which will never be repealed) provides a mechanism assuring that anyone will always get the most expensive form of care if they don't take other responsible measures to take care of themselves. This just results in economic inefficiencies that those of us that don't believe in a right to health care must continue to bear SOLELY because we are unwilling to let go of our small government ideals.

2. Third party payment systems themselves are too complex for Americans. Let's face it. Most of us posting on this thread lack the ability to read and understand the policies we are signing up for. And if we can understand it, we might be poorly equipped to really evaluate the nature of the risks that we should be taking. If you are shopping two policies or more (which we need to be doing to keep costs reasonable), then understanding the differences and the relative importance of the differences is also hard to sort out. If this is something that is relatively hard and time consuming - imagine what it must be like for people that didn't go to LaTech or have less life experience to understand what they really need.

What we have now is an entitlement in practice that because we don't want to call it what it is, we are bearing much more cost and profiting people that really have less to do with the delivery of the health care.

The policies themselves are the problem. Single payer will be catastrophic to healthcare. Fix the policy model. You don't need insurance for new tires, a car wash, or an oil change. You only need insurance for a high cost, unexpected, catastrophic accident.

Ironically, the average person sees a doctor 3-4 times per year...and the true cash cost with some profit built in is the same or less than an oil change.

[johnnylightnin]

The policies themselves are the problem. Single payer will be catastrophic to healthcare. Fix the policy model. You don't need insurance for new tires, a car wash, or an oil change. You only need insurance for a high cost, unexpected, catastrophic accident.

Ironically, the average person sees a doctor 3-4 times per year...and the true cash cost with some profit built in is the same or less than an oil change.

This seems plain. I used to have a major medical plan that functioned a lot like what you describe. That said, how likely do you think we are to move to something like what you propose? I don't hear anybody talking about it.

The GOP "solutions" are lame. Obamacare is lame too, but I think that was by design. Give the people what they ask for, but make it oppressively expensive. That way the people will ask for single-payer in time. I think, to that end, Obamacare has been a glowing "progressive" success.

[Dawgonit]

The policies themselves are the problem. Single payer will be catastrophic to healthcare. Fix the policy model. You don't need insurance for new tires, a car wash, or an oil change. You only need insurance for a high cost, unexpected, catastrophic accident.

Ironically, the average person sees a doctor 3-4 times per year...and the true cash cost with some profit built in is the same or less than an oil change.

One economist analyzing healthcare brought up an interesting point. He said that it might be incorrect to think there would ever be a true free market for healthcare since healthcare as a labor or resource can't be comparable to other consumer goods. For example tires are consumer goods. People have time to shop around and compare different prices. If the prices of tires are too high nobody will buy them and prices will have to drop due to drop in demand. However healthcare isn't the same. Many times people can't wait and shop around for healthcare like tires. If you have a deadly accident, you can't stop and compare prices of hospitals, ambulances, and doctors. You can't wait for prices to drop or spend time finding another price. People will pay any price because it's a necessity to live and its an emergency.

And this goes into what Guisslapp has said. We can say that people should have chosen better with their money and had insurance then for an emergency. A very capitalistic viewpoint and a valid argument for the viewpoint. However the problem is that nobody wants to let hospitals deny people at the door because they don't have money. Nobody wants to see people die because they can't get insurance due to a preexisting condition. A truly capitalistic healthcare system would have people dying of easily treated health problems due to different reasons. We don't view healthcare as something as solely a consumer good choice. Our personal and societies viewpoints on healthcare don't work well with a free enterprise model. We want government rules in healthcare. The amount of rules and regulations seems to be the debate as some want less and others want more. I understand too the frustration like Guisslapp. It seems the more we try to make a mixed model work, the more problems we seem to have. But no one wants to go toward a more capitalistic approach toward healthcare- society and people reject it.

[dawg80]

Every concern you express is exactly why we need a true market approach. Through a REAL* market approach there would be alternatives to insurance companies. Finance companies, including banks, can have vehicles like a line-of-credit (LOC) that one can draw on as needed. Yes, those with the sufficient collateral could qualify for such an LOC, many others couldn't. They would have to do something different. Not everyone is entitled to have access to every possible means to fund their HC.

* REAL? Well, that means guvmint needs to stay out of it, at least to the point of influencing markets. The only role I can see (and I might be convinced there should be ZERO role for guvmint) is a subsidizing fund for the very poor. But this would only be to help the very poor pay for private insurance, not a direct-pay plan in itself. In other words, bye bye to Medicaid for sure, and Medicare should also be phased out, or just quit cold-turkey and everyone who has paid into it, get a check for that total.

I am a free market believer! The actual number of incidents that are true emergencies are few and far between. If I break a bone, I can tolerate driving to Shreveport or Alex, instead of going to the Natch Hospital, if I can save some money. I won't die from a broken arm waiting one hour more. If I know, from advertising, I can save $250+ (just throwing a number out there) it might be worth it to me. How would I know? Hospitals will run TV ads trying to get my business.

I know people who drive to Houston or Dallas to buy cars/trucks, and even with the extra costs, they save maybe $2,000 or $3,000 versus buying the same vehicle locally. It's often a one or two-day trip, and the math works.

How much of healthcare is real emergencies and how much has the luxury of time? I'm guessing most of the expensive procedures where a patient does have time to shop around is 90% of services. Doctor tells ya, your gallbladder has to come out, or you have a frickin' hernia. You have time to find a low-cost provider.

[PawDawg]

The GOP "solutions" are lame. Obamacare is lame too, but I think that was by design. Give the people what they ask for, but make it oppressively expensive. That way the people will ask for single-payer in time. I think, to that end, Obamacare has been a glowing "progressive" success.

Obamacare got rid of the "hospitalization policies" you describe. I had one myself.

It is being talked about. Getting rid of the mandate is the first step. It allows folks like us to find another source for cat coverage like before the liberal democrats took over the system.

The RINO's and our president are afraid to upset those who think free healthcare is a right so they don't talk about it.

[HogDawg]

In Louisiana? And the rest of the states? Is there a similar cap?

You're obviously a lawyer. Typical.

Hey D80...that doesn't mean SD is a good one....


http://www.dancingwithlawyers.com/book/03-how-lawyers-think.shtml

http://thoughtcatalog.com/eleonora-l...ts-of-lawyers/