DOGE (4 Viewers)

[The_Doc_Man]

One issue is that any hospital that is owned by a publicly traded corporation doesn't answer to its patients. It answers to its shareholders. Another issue is that malpractice litigation insurance ain't cheap, but doctors who have bad records for malpractice "events" don't get their licenses revoked unless there was something so egregious as to even offend their peers. The system is therefore a bit "insular" and perhaps overprotects the bad apples that inevitably are found in ANY barrel (by law of averages).

I'm sure we could all identify cases in our past where someone was ill and the case was handled poorly. Long before I met my wife, I briefly dated a lovely lady "S" who had a chronic sinus infection. We parted ways before this condition worsened, but I found out later that the doctor handling S's case didn't address the purulent drainage in a timely manner and as a result, she passed away from toxic shock. Her sister, needless to say, was heartbroken and I mourned for S as well. But the doctor got away with it because no-one was willing to testify in court as to the proper treatment of her condition vs. the treatment she actually got.

 

[Isaac]

Wow, that's a sad story, poor S

You make good points all around. What if we created some fantastic legal/financial gizmo that actually incentivized hospitals and clinics to somehow answer to their patients in a more cooperative (i.e. co-op) manner, I wonder if that would help or is even possible. I have no idea how.

Please someone answer this question so I don't have to admit it might require just one more (last) piece of Regulation. (ha - I'm laughing at myself here).

 

[Thales750]

I know, I know ....

I believe the right perspective is to be 'scared' of things the government takes over, for all the reasons we've probably all posited and I won't here re-type ..... but in some cases I do agree to consider it. Still, pricing seems to be the issue. Doctors will say their 38,000$ surgery is legit. Insurance companies will say it's only worth $8k. Who's right, and who's wrong, and why? Until we get to the root cause of that, would the government actually do a BETTER and cheaper job? I'm unsure, honestly, but I think the exact wrong response is to just say, Tax someone a bit more and have the goverment pay for it. First we solve the pricing issue, then we consider making it universal or not

Everyone I know that has had parents, or themselves, been on Medicare has had good things to say about it. No one I know has ever praised their insurance company. Especially those that got denied life saving procedures.
Years ago one of the lines against Universal Health Care was do you want someone in Washington deciding if you need care. Well, the obvious answere is, no let's just let Wall Street decide.

 

[Thales750]

Something you are intimately familar with...

Exactly, when I listen to you guys.

 

[Isaac]

Everyone I know that has had parents, or themselves, been on Medicare has had good things to say about it. No one I know has ever praised their insurance company. Especially those that got denied life saving procedures.
Years ago one of the lines against Universal Health Care was do you want someone in Washington deciding if you need care. Well, the obvious answere is, no let's just let Wall Street decide.

I've had fairly good luck with insurance companies, as long as I do a good job choosing - for example, my sister has a horrible experience but she chose a HMO, I wouldn't come near them with a 10 foot pole. However you do make a good point, my parents are on an implementation of medicare in Wisconsin which has been pretty good for them. How do you feel government would do about pricing though? Other than the idea of simply saying "this procedure can never cost more than __", which would be silly - as it ignores the realities that doctors offices have to hire like the 10 roles of people to do something simple, like my other post which expounded on that quite a bit. There would have to be a fair amount of litigation capping I think. Allow some, yes, but have true caps. Which BTW is a great idea I think all around for tort claims of all kinds, the problem is it runs into contrary principles of contract law and the rights of juries and courts to mete out justice and 'equity' ($)

 

[Thales750]

I've had fairly good luck with insurance companies, as long as I do a good job choosing - for example, my sister has a horrible experience but she chose a HMO, I wouldn't come near them with a 10 foot pole. However you do make a good point, my parents are on an implementation of medicare in Wisconsin which has been pretty good for them. How do you feel government would do about pricing though? Other than the idea of simply saying "this procedure can never cost more than __", which would be silly - as it ignores the realities that doctors offices have to hire like the 10 roles of people to do something simple, like my other post which expounded on that quite a bit. There would have to be a fair amount of litigation capping I think. Allow some, yes, but have true caps. Which BTW is a great idea I think all around for tort claims of all kinds, the problem is it runs into contrary principles of contract law and the rights of juries and courts to mete out justice and 'equity' ($)

The same exact people that make profit off of malprtice insurnce make profit off of health care insurance. As you have said dealing with insurence companies is expensive in term of effort required. Then there is the huge amount of daily interest in the float for this much money 4.5 trillion per year in the US alone. That interest has been instrmental in building China using American investment for 35 years. Think about that half of Amercan think Universal Health Care is socialist, and the other half follows the liberal dog wagging tails. Who has benefited the most?

The finacial sector of course.

 

[AccessBlaster]

There are health care alternative services like medi-share

 

[Isaac]

When I was little, I was taught a term: "Unfunded mandates". Despite what it may have very specifically meant at first, I think as a concept it applies to so many regulations in this country. "Start doing this" as a command to a business, like a doctor's office, or "start doing this or automatically be considered liable in a tort claim" ..... And the business is left thinking well Gee, that is going to cost time, people, = money.

Start with letters. If I log into my mortgage account and edit my phone number, switch to paperless, schedule a payment, etc., I get 3 physical letters in the mail letting me know I did these things...That's ridiculous. But I'm pretty sure it wasn't the business's idea necessarily, it came from some dumb law that requires notification upon X, Y, and Z. God forbid I renew my auto insurance policy, I get 10 packets in the mail, all of which immediately go in the recycle bin, as they're all online anyway. Some of which are mandated by the State. When I log into Ebay, I get several emails immediately letting me know I logged in, logged out, letting me know I updated something, just a bunch of crap. All of these things cost MONEY - hiring programmers and business analysts to decide how to design it and code it and keep up with the constant changes. Yes some of it is the business own desire - marketing, security and the like - but some of this extreme over-communication is because of government regulation and worry about being sued for something.

We cannot just keep saying "raise taxes a tiny bit, let the government handle it", we have to address the root of why things are twice as expensive here as in Europe, in many cases.

 

[Thales750]

When I was little, I was taught a term: "Unfunded mandates". Despite what it may have very specifically meant at first, I think as a concept it applies to so many regulations in this country. "Start doing this" as a command to a business, like a doctor's office, or "start doing this or automatically be considered liable in a tort claim" ..... And the business is left thinking well Gee, that is going to cost time, people, = money.

Start with letters. If I log into my mortgage account and edit my phone number, switch to paperless, schedule a payment, etc., I get 3 physical letters in the mail letting me know I did these things...That's ridiculous. But I'm pretty sure it wasn't the business's idea necessarily, it came from some dumb law that requires notification upon X, Y, and Z. God forbid I renew my auto insurance policy, I get 10 packets in the mail, all of which immediately go in the recycle bin, as they're all online anyway. Some of which are mandated by the State. When I log into Ebay, I get several emails immediately letting me know I logged in, logged out, letting me know I updated something, just a bunch of crap. All of these things cost MONEY - hiring programmers and business analysts to decide how to design it and code it and keep up with the constant changes. Yes some of it is the business own desire - marketing, security and the like - but some of this extreme over-communication is because of government regulation and worry about being sued for something.

We cannot just keep saying "raise taxes a tiny bit, let the government handle it", we have to address the root of why things are twice as expensive here as in Europe, in many cases.

Most of what you are talking about is not really about regulations. It's about our litigious society.

 

[Isaac]

Most of what you are talking about is not really about regulations. It's about our litigious society.

That's probably true, I'm saying regulations and litigation

 

[Pat Hartman]

Until we get to the root cause of that, would the government actually do a BETTER and cheaper job?

Not if they are going to pay the surgeon $8,000 instead of the $38,000 he asked for. How long will doctors work for slave wages (in their minds)?

Anyone who bothers to read their EOB's sees this problem every month. I have spoken about this multiple times with hard, personal, examples. This is the problem the ACA should have addressed directly. All it takes is requiring providers to post fees openly. We already have a health tourism industry in the US because surgeries that are considered optional like knee replacements, may not always be covered by insurance and the cost is significantly different in different cities around the country. So, you, and a companion, may be able to go to another city, stay for a week and recuperate and still spend half what it would have cost at home.

 

[Isaac]

Not if they are going to pay the surgeon $8,000 instead of the $38,000 he asked for. How long will doctors work for slave wages (in their minds)?

Anyone who bothers to read their EOB's sees this problem every month. I have spoken about this multiple times with hard, personal, examples. This is the problem the ACA should have addressed directly. All it takes is requiring providers to post fees openly. We already have a health tourism industry in the US because surgeries that are considered optional like knee replacements, may not always be covered by insurance and the cost is significantly different in different cities around the country. So, you, and a companion, may be able to go to another city, stay for a week and recuperate and still spend half what it would have cost at home.

I agree, that's why I said the government can't just pass a rule that says the price can only be such and such unthinkingly.

 

[Thales750]

Not if they are going to pay the surgeon $8,000 instead of the $38,000 he asked for. How long will doctors work for slave wages (in their minds)?

Everyone is. Doctors are at the top of the AI chopping block. Just like database developers, and interstate truck drivers. You really haven't had a vision of what's coming have you?

 

[Thales750]

Trump Co must have been reading this thread and listened to me.
He's removing the tariffs on car parts. Or so he claims today.

 

[AccessBlaster]

Trump Co must have been reading this thread and listened to me.
He's removing the tariffs on car parts. Or so he claims today.

I've noticed you guys have moved off the tariff rant and onto the new shiny object. You can’t land a punch because he keeps ducking and moving forward.

 

[Thales750]

I've noticed you guys have moved off the tariff rant and onto the new shiny object. You can’t land a punch because he keeps ducking and moving forward.

I mention he did one thing right and you hink I've moved on. Lol

 

[AccessBlaster]

I mention he did one thing right and you hink I've moved on. Lol

Collectively speaking

 

[Thales750]

Collectively speaking

It's eronious to lump me in with them. It's useless, and it keeps you from learning anything from me. That's your loss.

 

[AccessBlaster]

It's eronious to lump me in with them. It's useless, and it keeps you from learning anything from me. That's your loss.

Actually, I learn a lot from every post, people like you push my boundaries.

 

[Pat Hartman]

How do you feel government would do about pricing though? Other than the idea of simply saying "this procedure can never cost more than __", which would be silly - as it ignores the realities that doctors offices have to hire like the 10 roles of people to do something simple, like my other post which expounded on that quite a bit.

That is exactly how medicare works and is the reason that not all doctors will accept it. If you think that the Medicare prices which all hospitals accept and most doctors accept, are rational, then the "rack rate" is completely irrational. Hospitals use cost accounting systems to determine how much a service costs so you get some really stupid numbers like $10 for two aspirin and $15 for paper slippers. As far as doctors go, they have the overhead of running an office and of course the dreaded insurance problem. If any of you have recently been treated in a hospital, pull out your EOB if you can find it to see what the hospital tried to charge your insurance company and what they got paid.

In fact, Hospitals may also try to write off the difference between what they tried to charge and what insurance paid as uncollectible. So if they billed $100 but got paid $45 by the insurance company, they may be trying to write off $55 as non-payment. Hospitals should at least be forced to use the Medicare rates or maybe an average of ALL insurance rates for each procedure when writing off non-payment because they are forced to treat illegal aliens as well as uninsured citizens so that dramatically ups the non-payments since most citizens end up with at least some insurance rather than pay the fine imposed by the IRS. Instead, they pull the highest possible rates out of their a**, which NOBODY EVER PAYS and use that as the write-off amount. If you are solvent but uninsured, the hospital will try very hard to get you to pay exorbitant rates but will negotiate down if they feel they have to.

Every medium sized city used to have at least one charity hospital. Many were run by religious orders. They've been gone for years. I had two surgeries at the Catholic charity hospital as a child. Near as I can tell, the treatment was good and the nuns were very kind and caring.