MoreGooder

See! I learned something very important today. I think the one good thing that will come of the movie is a better educated and informed public. Exposure like this will cause change! Hopefully, for the better.

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

Hambergler

Non-Profit is nothing but a word. 80% of hospitals are non profit. There are no set guidelines for reaching this status. And there is currently no way of enforcing charitable obligations. You would think the IRS would police this because of the incredible benefit of tax exempt status, but there is nothing done. And they offer very little benefit to there community. It is common practice to charge patients what they charge the insurance companies, the difference is the insurance companies only pay what they want, usually a percentage.The usually poor cash paying is charged the entire amount. Don't believe for one second they aren't extremely aggressive about getting their money. Name one hospital that is operating at a loss. Public hospitals work the same way except, you get sub-par care. My advice for people here is tape your insurance card to you forehead. If you get into an accident and you cant show them your insurance card they will take you to a public hospital. You will get treated by a med student and may be an unknowing participant in experimental procedures. The standard of care is really anyones perspective and so is experimental practices. If something is obviously not approved by the FDA they go down to Mexico and practice on them till they get it right. The class system is obvious here. And healthcare is regarded as a luxury for the rich and healthy.

The amount cobra costs represents what my employer was paying for me. If you are saying cobra is broken. Then you are saying the insurance companies are broken because they are the same thing. What my employer pays for me in health benefit is factored in to my salary. So it is just like a tax.

There is a growing trend for insurance companies to pay what Medicare pays. So reimbursements are getting closer and closer to government standards. We may be in the midst of a slow transition into government controlled medicine, or it may be that the insurance companies using the government payment schedule as an excuse to pay less. Who knows.

The only way to cap salaries is to have government controlled medicine. I think people who are against it have bought into propaganda or have never had a serious health issue denied. What if the police were privately owned. And you had to have very expensive insurance to call them or else they would charge you an arm and a leg. Let the trailer trash kill each other, who cares right? Just think what a boring show cops would be.

__________________

MoreGooder

Well, Hambergler (humm... somehow I'm craving McDonalds right now), if what you are saying is true the a movie like Sicko will serve as a catalyst to expose the truth.

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

jaymind

I'm sorry Hambergler, but I'm going to disagree. I've worked for multiple non-profit hospital systems and it's non just a word to them, but maybe things are different in the mid-west than they are in the south.

My current hospital takes 80% of it's net profits every year and re-invests that money back into the system in some form. We've bought rural hospitals that are no more than 10 beds and kept them running at a loss so that people had access to care closer to home. Most healthcare systems do what they can (most are Christian based), but they do have to remain in business so that puts a practical cap on what they can do.

It gets real easy to point fingers at the healthcare system as a whole, but ultimately it's not their fault. Blame insurance companies, HMO's, Medicare, rising drug costs, rising costs of damn near anything.

Any healthcare system that is still in business today (for the most part) is running incredibly lean alrady because of medicare, there is very little room for more operational costs cutting.

Every system I've worked with provided a way for anyone to get treated, regardless of their ability to pay. Every one of them had free clinics setup for anyone. Magically handing over the reins of the healthcare industry to the government (who can't get Medicare right) is asking for a disaster. Check out the Medicare system and the VA system, then get back to me and let me know if you want the government running all healthcare.

Let the government control the insurance industry where they are the most needed and where the actually crooks are.

MoreGooder

Thanks for clarifying.

One thought wrt "abiity to pay". Techinically, I have the ability to pay given that I have insurance. What I don't have the ability to pay my deductible and out of pocket expenses without breaking out the credit cards. After 12 months, guess what? I would start all over again with a brand new deductible and start crawling up the "max out of pocket" road.

Like I said in my earlier post. Health care is not a problem if your dirt poor or fabulously wealthy. It's the middle class that suffers from this, and it's hurting the economy as a whole.

I can't wait for this movie to hit Blockbusters.

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

Hambergler

My uncle has been on disability for 2 years. He still employees 4 fulltime people and all they do is fight with insurance companies over care he gave 2 years ago. So I agree insurance companies are just as much at fault. I have been in healthcare for 12 years. I have worked very closely with my father who was the sole owner/operator of a surgery center and 3 full service imaging centers before he died. I have also worked at hospitals. I have two uncles who are surgeons and countless doctors who are personal friends and I have assisted in thousands of surgeries. I have seen the true business dealings of healthcare from all angles. If you want to buy into the peachy numbers the non profits out up to toot their own horn thats up to you. Funding a ten bed hospital is nothing more then CYA, I wonder how many people had to die on their way to the hospital first. Check the salaries of the non profit execs. How is non profit and 8 million dollar salary in the same sentence? I can tell you about frivolous surgeries, kick backs, patients who have died because of insurance denial, milking terminal patients insurance with with BS tests with no hope for survival, the list goes on and on. This is all because the driving motivation is greed.

The hospital will treat you regardless of your ability to pay in the emergency room. There are many disorders that do not qualify for ER visits. Or can prevent someone from reaching the edge of there life, before they have to hit the ER. On top of that they will charge you up the wazzoo and then ruin your credit and put you in debt for the rest of your life.

The VA has problems because they are the step child of the healthcare industry. If proving health care was the driving force in the healthcare system the VA should be the best place to go. Using the VA as a model for what happens in a government controlled healthcare system is unfair because it is part of the current healthcare system.

Why can't there be a governing body with the integrity of the supreme court or the federal reserve to over see healthcare. I just don't believe my health should be in the hands of the wild west of the corporate world.

__________________

Kerostasis

And how do you propose to produce more of these types of people? Magic?

I swear, you people act like you can wave a magic wand at the healthcare industry, say "be less greedy!", and expect health care costs to drop just like that.

I spend a lot of time in fantasy worlds too, but at least I know how to tell the difference when I come back to the real world.

__________________

MoreGooder

No one is claiming magic beans are required. No one is looking for unrealistic solutions.

And, just who are you referring to with "you people". You're included in this. We all are, unless you fall into the fabulously wealthy and don't-give-a-rats-ass category.

*edit* Toned my response down a bit.

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

MoreGooder

My employer just started offering free annual checkups, after I mentioned them in a meeting. Got the CEO thinking. Preventive care does pay in the long run. Catching cancer and heart disease in the early stages can pay off big time. In fact, I don't think it will be long before insurance companies mandate that all patience to go get a free checkup once a year, otherwise coverage is dropped. Afterall, it's their money their trying to save. The flip side is that perhaps the gov. will require insurers to adopt that policy.

Next sub-topic: How many of you are smokers? Do you pay more premium?

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

Kerostasis

[reply to removed portion has been removed--my thanks for making that unnecessary]

Nowhere in this thread did you, or anyone else, propose a non-magical mechanism for finding more people willing to do the same job for less money. If there were enough of those to meet demand, they would all be employed already TODAY and the people who wanted to charge more would be out of business. But that hasn't happened, because we have shortage of medical professionals rather than a surplus. And you don't fix shortages by lowering the price.

When I say "you people", I dont mean "people who need healthcare", I mean "people who expect the government to fix healthcare". I am part of the first group, yes, but not part of the second.

__________________

jaymind

I don't disagree with some of what you are saying, particularily with establishing a governing body, although I take a very strong objection to generalization of healthcare. Everyplace I have worked is so far from what you state that I can't imagine it. I know exactly what my hospitals systems execs make to the penny. I know how much revenue our system makes and I know how much goes out to helping people, upgrading facilities, salaries, etc. because I help control the systems that garner those numbers. If it's that screwed up in the south then you have a real problem, but it ain't like that here or anywhere I have worked.

However, as much as you'd like to trivialize how VA's are, they are a government run healthcare system that is so screwed up that they will never get set straight without starting over. I just don't want to see government controlling all aspects of healthcare - I would rather see an expansion of the Medicare system (cleaned up of course) instead.

Everything falls back to insurance. I would take exception to any physician or healthcare system that turns people away because of money - mine won't, it's against the fundamental principle of the system. However, if you can pay you should or we won't have any hospitals left to treat anyone.

Free healthcare would be great, but ain't nothing for free. So, where should the money for universal coverage come from? How much should we raise taxes to cover everyone? Should I have to help cover idiots who smoke and get lung cancer? How does that roll into it? Is it fair to make everyone pay a part of someones coverage if they live a high risk lifestyle? Should my money that I worked hard for go to cover people that abuse the system, like those that live on wellfare because they don't want to work and expect handouts from those that do?

From your tone, it's obvious you feel nothing but disdain for anything in the healthcare field so what are your answers? Nationalize it completely? I have good healthcare, so should mine get worse to make others better?

There are no generalizations here, and there are no easy answers and anyone that says differently is an idiot.

snooggums

Smokers should not pay more. People do a lot of stupid things that get themselves injured so picking one type of legal behavior is discriminatory.

MoreGooder

I think we've established that there is no easy answer. That we could have assumed right from the start.

First, wrt expecting people to take less money for the same job. I'm suggesting that market forces through competition drive down those costs, same as it did for the IT industry in the 90's. That's the way it's done in a capitalists society.

Hummmm.... wait a minute. We've already tried that. In fact, we've been trying it for decades now.

Has the existence of many doctors in the same specialist field in one metro area driven down the costs of the services they offer? (I'm assuming the answer is "no" for most of them, once you take out Lasix and plastic surgery. Correct me if I'm wrong). Why has it failed. Perhaps its because insurance companies don't force people to go to a particular doctor who offers a lower price for the same service? Oh, that's called an HMO, nevermind. Been there, done that, hated it.

It appears that we've already tried everything. We know other countries have successful universal health care systems, and the quality of care is excellent. Isn't that the next logical step?

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

MoreGooder

I think the difference is that smoking is a known risk factor for particular diseases. But, to support your arguement, breaking your neck in a car accident because you were driving 10 mph over the legal limit is arguably just as self-destructive.

I raised the question for that very reason. I'm not a smoker, but I have many friends and family members that are. They all have some level of health insurance. My brother pays considerably more for his insurance because of it.

I have a friend that jumps out of airplanes for fun. He doesn't pay anything extra, but perhaps he hasn't disclosed this to his insurer. Most likely, in the fine print, his policy indicates accidents due to risky behavior isn't covered. I might ask him next time I see him.

Of course, we can't live our lives without some level of risk. We'd never walk up and down stairs otherwise. It all comes down to the question of what defines reasonable culpability.

__________________


Sometimes I feel like 2/3'rds Rice Krispies. Past "Snap" and "Crackle" but just shy of "Pop"!

Kerostasis

Did you actually pay attention to HOW the market forces drove down costs in the IT industry in the 90s? Or do you just assume the same process can mostly likely be applied unchanged to any market you want?

The 90s IT boom, and the promise of big bucks, encouraged large numbers of people to get the necessary training to become IT people, so the supply of workers expanded. Shortly thereafter, the dot com bust meant there were less companies offering jobs to IT people, so the demand for workers declined. The combination of declining demand and increasing supply drove down the cost.

Meanwhile, demand for medical care never decreases...it just goes up and up and up. Every time a new procedure becomes available that wasnt before, it generates new demand for people to supply it. Every time a new breakthrough extends our lifespan, it generates new demand to solve all the extra health problems suffered by people living longer than they used to.

The supply of medical professionals is also growing, but not quickly enough to keep up with demand. The market process that drove DOWN costs for IT workers is driving UP costs for medical workers as a way to try to solve the demand gap. They will keep going up until we manage to attract enough workers to actually supply all the medical procedures we insist on having done.

If you want to curb costs, you need to either find a way to cut demand (not politically feasible even though I think it would be the most effective solution) or increase supply. For example, increased college grants to students majoring in medicine or something. Maybe advertising on how awesome it would be to sign up for a medical program. I don't know. Feel free to brainstorm that, but simply mandating "medical workers must accept lower paychecks", or "medical workers must provide free service for humanitarian resons", is not the answer.

__________________